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Peripheral Vascular Angioplasty
What you need to know about peripheral vascular angioplasty:
Peripheral vascular angioplasty is a procedure to open blocked or narrowed arteries in your legs. The procedure can help reduce symptoms of poor blood flow, such as pain, numbness, and wounds that will not heal. The procedure may also prevent the need for an amputation of your leg or foot.
How to prepare for peripheral vascular angioplasty:
- You may need blood tests, an angiogram, or an electrocardiogram (ECG) before your procedure. Talk to your healthcare provider about these or other tests you may need. You will need someone to drive you home and stay with you after your procedure.
- Your healthcare provider will talk to you about how to prepare for your procedure. He or she may tell you not to eat or drink anything after midnight on the day of your procedure. He or she will tell you what medicines to take or not take on the day of your procedure. You may need to stop taking blood thinners several days before your procedure. Ask your healthcare provider if you can continue taking aspirin.
- You may be given an antibiotic through your IV to help prevent a bacterial infection. Contrast liquid may be used during your procedure. Tell a healthcare provider if you have ever had an allergic reaction to antibiotics or contrast liquid.
What will happen during peripheral vascular angioplasty:
- You may be given general anesthesia to keep you asleep and free from pain during your procedure. You may instead be given IV sedation to make you feel calm and relaxed during the procedure. You may also be given local anesthesia to numb the area. With local anesthesia, you may still feel pressure or pushing, but you should not feel any pain.
- Your healthcare provider will insert a catheter and wire into a blood vessel in your arm, wrist, or groin. He or she will move a wire through the catheter and up into your blocked artery. Your healthcare provider may inject contrast liquid so he or she can see your artery more clearly on the x-ray. You may feel warm when the contrast liquid is injected. Your provider may use a balloon to help open your artery. He or she may measure oxygen and pressures in different parts of your arteries. A stent may be inserted through the catheter and into your artery. The stent helps hold the artery open so blood can flow through easier.
- Your healthcare provider will remove the catheter and wire. He or she may use clamps, stitches, or other devices to close the wound. Pressure will be applied to the wound for several minutes to stop any bleeding. A pressure bandage or other pressure device may be placed over the wound to help prevent more bleeding.
What will happen after peripheral vascular angioplasty:
- You will be attached to a heart monitor until you are fully awake. A heart monitor is an EKG that stays on continuously to record your heart's electrical activity. Healthcare providers will monitor your vital signs and pulses in your arm or leg. They will frequently check your pressure bandage for bleeding or swelling.
- You will need to lie flat with your leg or arm straight for 2 to 4 hours. Do not get out of bed until your healthcare provider says it is okay. Arm or leg movements can cause serious bleeding. You may be able to go home or you may need to spend a night in the hospital.
Risks of peripheral vascular angioplasty:
You may bleed more than expected or get an infection. You may have bruising or pain where the catheter was. You may need surgery to repair damage from the catheter to your blood vessels or to stop heavy bleeding. You may get a blood clot in your arm or leg. The blood clot may break off and travel to your lungs, heart, or brain. This may cause a heart attack or stroke. The contrast liquid may cause kidney damage or an allergic reaction.
Call 911 for any of the following:
- You have any of the following signs of a heart attack:
- Squeezing, pressure, or pain in your chest
- and any of the following:
- Discomfort or pain in your back, neck, jaw, stomach, or arm
- Shortness of breath
- Nausea or vomiting
- Lightheadedness or a sudden cold sweat
- 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
- You cough up blood.
- You have trouble breathing.
- You cannot stop the bleeding from your wound even after you hold firm pressure for 10 minutes.
Seek care immediately if:
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- Blood soaks through your bandage.
- Your stitches come apart.
- Your leg or arm feels numb, cool, or looks pale.
- Your wound gets swollen quickly.
Contact your healthcare provider if:
- You have a fever or chills.
- Your wound is red, swollen, or draining pus.
- Your wound looks more bruised or there is new bruising on the side of your leg or arm.
- You have nausea or are vomiting.
- Your skin is itchy, swollen, or you have a rash.
- You have questions or concerns about your condition or care.
You may need any of the following:
- Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
- Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
- Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
- Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
- Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
- Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
- Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
- You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
- Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
You may be able to shower the day after your procedure. Remove your pressure bandage before you shower. Do not take baths or go in hot tubs or pools. These actions can increase your risk for an infection. Carefully wash around the wound with soap and water. Pat the area dry.
Care for your wound as directed:
Change your bandage when it gets wet or dirty. A small band-aid can be placed on your wound after you remove the pressure bandage. Monitor your wound every day for signs of infection, such as redness, swelling, or pus. Mild bruising is normal and expected. Do not put powders, lotions, or creams on your wound.
- Apply firm, steady pressure if bleeding occurs. A small amount of bleeding from your wound is possible. Apply pressure with a clean gauze or towel for 5 to 10 minutes. Call 911 if bleeding becomes heavy or does not stop.
- Do not lift anything heavier than 5 pounds for 48 hours. Heavy lifting can put stress on your wound and cause bleeding. Do not push or pull with the arm used for the procedure.
- Do not do vigorous activity for at least 48 hours. Vigorous activity may cause bleeding from your wound. Rest and do quiet activities. Short walks to the bathroom and around the house are okay. Do not walk or stand for more than 10 minutes. Ask your healthcare provider when you can return to your normal activities.
- Limit stair climbing to prevent bleeding from your wound. Plan activities on 1 floor. Limit stairs to 2 times a day.
- Drink liquids to flush the contrast liquid from your body and prevent blood clots. Ask how much liquid to drink each day and which liquids are best for you.
- Restart your blood thinners as directed. Your healthcare provider may tell you to start taking your blood thinners after your procedure, or he or she may have you wait a few days.
- Ask your healthcare provider how to manage or prevent peripheral artery disease. He or she can help you create a healthy eating plan, exercise plan, or weight loss plan. Do not smoke. Nicotine and other chemicals in cigarettes and cigars can block your arteries. They can also increase your risk for heart disease, heart attack, and stroke. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
Follow up with your healthcare provider as directed:
Write down your questions so you remember to ask them during your visits.
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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.