Angioplasty and Stenting

Basic Facts:

  • Atherosclerotic plaque can build up inside arteries and block the normal flow of blood, limiting the amount of blood that reaches body tissues (like heart, brain, legs and kidneys).
  • Angioplasty and stenting are performed when plaque buildup narrows or blocks an artery or, occasionally, when veins become narrowed or blocked from blood clots.
  • During angioplasty, a tiny balloon is placed inside the artery and inflated to crack and compress plaque buildup, expand the diameter inside of the blood vessel and increase blood flow.
  • Stents are slender metal-mesh tubes that are mounted on the outside of the balloon. When the balloon is inflated, the stents expand inside a blood vessel to provide support and keep blood vessels wide open.
  • As people age, the normal flow of blood through the arteries can be affected by the buildup of plaque inside the arteries. Over time, plaque continues to grow on arterial walls as cholesterol circulates in the blood; as the plaque enlarge, the arteries become narrow and stiffened. This process is called atherosclerosis, commonly known as hardening of the arteries, because the plaque buildup thickens the walls of the arteries and narrows the space through which the blood flows. When this happens, it reduces the circulation of blood through the area of the body that gets its blood from the artery.
  • Angioplasty is a procedure during which a physician inflates a small balloon inside a blood vessel to eliminate or reduce areas of narrowing. The goal of angioplasty is the restoration of adequate blood flow (revascularization) through the affected part of the body. This is accomplished by enlarging the blood vessel from within.
  • Stenting is a procedure in which the physician inserts a tiny, slender, expandable metal-mesh tube (stent) that fits inside an artery once the artery has been widened by angioplasty. The goal of stenting is to prevent the arty from collapsing or being closed by plaque again.

When are angioplasty and stenting indicated?

Atherosclerosis can cause a variety of diseases or conditions depending on the location of the plaque within the body. Some of these include:

  • Coronary heart disease
  • Carotid artery disease
  • Aortoiliac occlusive disease
  • Leg artery disease
  • Arm artery disease
  • Visceral artery conditions
  • Renovascular conditions

In less advanced cases of atherosclerosis, medication is the first line of treatment; when atherosclerosis is advanced or does not respond to medication, angioplasty and stenting are recommended. In many cases, angioplasty is an alternative to bypass surgery.

Conditions that can affect the flow of blood through the venous system, such as deep venous thrombosis and portal hypertension, are sometimes treated with forms of angioplasty. Angioplasty may be used to treat blocked surgical bypasses when they occur.