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Endovascular Cryoplasty

What you should know

  • Endovascular cryoplasty, also known as cryoplasty (CRY-o-plah-stee), is a type of balloon angioplasty (AN-g-o-plah-stee) procedure. It is used to treat peripheral vascular disease (PVD). Cryoplasty is therapy that uses pressure and cold to open blocked or narrowed arteries. Arteries are blood vessels that carry blood with oxygen from your heart to another part of the body. They can become clogged by plaques that decrease blood flow in the artery. Plaques are fat, cholesterol, or tissues that get stuck in the inner wall of the artery. Cryoplasty is often used to open clogged arteries in the legs. Decreased blood flow may cause severe leg pain and trouble walking that can affect your quality of life.
  • With cryoplasty, a small balloon-tipped catheter is put into a large blood vessel in the groin. The groin is the area where your abdomen (stomach) meets your upper leg. The catheter is passed down into the area of the clogged area of the artery. The artery is opened and cooled using a high pressure balloon filled with nitrous oxide (laughing gas). Cryoplasty may be done after caregivers strip and cut the plaque first. It may also be followed by stenting. Stenting is a procedure that places small tubes in the area where the blockage was removed to keep the artery open. Having cryoplasty may improve the blood flow in your leg to relieve your symptoms and avoid further problems.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

Your symptoms, such as pain, cramping, and numbness in your legs, may worsen without treatment. If parts of your leg do not get enough blood and oxygen, the leg may need to be amputated (cut off). Having PVD may also lead to a heart attack or stroke (blood clot in the brain). Problems with cryoplasty may include infection, trouble breathing, and getting blood clots. Even after the procedure, the artery may become narrow again. The blood vessel used for the procedure may tear, causing you to lose a large amount of blood. Ask your caregiver if you are worried or have questions about your procedure, medicine, or care.

Getting Ready

The week before your procedure:

  • Ask a family member to drive you home after your procedure. Do not drive yourself home.
  • Ask your caregiver if you need to stop using any of your present medicines. If you take aspirin, ibuprofen, or blood thinners, do not stop taking them without asking your caregiver.
  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  • Tell your caregiver if you know or think you might be pregnant.
  • You may need to have blood tests, an electrocardiogram (ECG), chest x-ray, and other tests. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your procedure:

  • Remove any nail polish.
  • You may be given medicine to help you sleep.
  • Ask caregivers about directions for eating and drinking.

The day of your procedure:

  • Write down the correct date, time, and location of your procedure.
  • What to bring: You may want to bring items such as a toothbrush and bathrobe.
  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.
  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

  • You will be asked to change into a hospital gown. You may be given medicine to help you relax or make you drowsy. You will be taken on a stretcher to the room where the procedure will be done. X-rays with a TV screen will be used to guide caregivers during the procedure. Caregivers will clean your skin and sheets will be put over you to keep the area clean. You will get medicine called a local anesthetic to numb the groin area where the catheter will be put into you. A small balloon-tipped catheter is then put into an artery through a small puncture or cut (incision) made in your right or left groin.
  • Dye may be put in the artery to make the blocked area show up better. The catheter is pushed forward until it reaches the spot where the artery is clogged with plaque. Then nitrous oxide is used to make the balloon expand. The gas is let out of the balloon after about 20 seconds and the balloon moved to another clogged area. Dye is again put into the artery and pictures are taken. This is to make sure that blood can flow easily through the artery. After all areas are treated, the catheter is removed. The incision is closed with stitches (threads) and covered with tight pressure bandages.

After your procedure:

To prevent bleeding, you will need to lie flat in bed for a time. You may have a sandbag placed on your groin for 4 to 6 hours. Keep your leg straight and do not move the leg where the cryoplasty was done. Do not get out of bed until your caregiver says it is OK. Caregivers will watch you closely for any problems. When caregivers see that you are OK, you may be taken to your hospital room or you may be able to go home after the procedure. The bandages used to cover your stitches will keep the area clean and dry to help prevent infection. Caregivers may remove the bandage soon after the procedure to check the incision.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

  • You cannot make it to your procedure on time.
  • You have a fever.
  • You have a wound near the area where the procedure will be done.
  • You have questions or concerns about your procedure.

Seek Care Immediately if

  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Trouble breathing
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing
  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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