Angioplasty and stenting

Introduction

An angioplasty is a way of relieving a blockage or narrowing of a blood vessel. A fine plastic tube called a catheter is inserted into the artery (vessels that supply blood to your body). A special balloon on this catheter is inflated in the narrowed or blocked area. This will either clear the blockage or widen the blood vessel to improve blood flow.

If the angioplasty does not improve the flow, a stent may be inserted. A stent is made of metal and is shaped like a tube. It will be placed in the narrowed part of your artery and will hold it open. The stent will remain in your body forever, but you will not be able to feel it.

Before you come in

Please let the X-ray nurses know if you take warfarin, aspirin or clopidogrel (tablets to thin the blood), metformin (tablet for diabetes), have asthma or any allergies. You will need to have a blood test the week before your appointment.

Please arrange to have an escort home (must be a responsible adult) after your discharge from hospital.

Risks and benefits

The benefit of this procedure is it will help to treat your symptoms while avoiding the risks of surgery. It is a relatively safe and short procedure with a quick recovery time. It is common to feel pressure when the balloon is inflated, and to have some bruising in your groin after this procedure. There is a very small risk of bleeding, or a reaction to the dye such as nausea or a rash. There is small risk of infection or damage to the blood vessel following which a surgical operation may sometimes be necessary. All of the risks and benefits will be discussed with you before your procedure.

Before you come in

Please do not eat or drink for 6 hours before your procedure. Please take all your medications as usual (except aspirin, warfarin or clopidogel) and, if you are diabetic, you may take your regular medications.

Day of your procedure

You will be admitted to hospital. On the ward your nurse will ask you about your health and current medication. Your blood pressure and pulse will also be checked. They will ask you to change into a gown. Your nurse will bring you to the X-ray department on your bed. 

In the X-ray department you will be seen by a doctor who will discuss the procedure with you before you sign a consent form. Please ask any questions you may have as it is important that you understand what is going to happen.

During the procedure

In the room you will lie on an X-ray bed. You will be asked to remove your underwear, your groin will be cleaned with antiseptic fluid and you will be covered with a sterile sheet. The doctor will give you an injection of local anaesthetic to numb the skin in your groin which will cause some stinging initially and then go numb.

Throughout the procedure, a nurse will be with you who will monitor your pulse and blood pressure. A catheter (fine plastic tube) will be inserted into your artery. Dye will be injected through this catheter while X-ray pictures are taken. It is normal to experience a warm flush and a metallic taste in your mouth caused by the dye. The doctor will place the balloon catheter across the narrowed area and inflate the balloon. This may need to be repeated for the narrowed area to open up enough.

If you require a stent, the doctor will insert this across the narrowed area. We will explain what is happening throughout the procedure. The procedure usually lasts 60–90 minutes but may take longer.

After the procedure

You will return to the ward where your nurse will monitor you regularly. After 2 hours you may be able to sit up and, if there are no concerns, after a further 4 hours of resting, you will be able to mobilise.

Going home

After your procedure, you will be required to spend the first night in hospital and can usually go home the following day.

After you are home

• You must avoid driving for 24 hours.
• You must avoid sport, excessive activity or lifting anything greater than 5 kg (11 lb) for the next 2–3 days.
• Remove the plaster from your groin the following day. It is normal to have a very small amount of bleeding from the wound. Tenderness can last for a week, and bruising can last for 2 weeks. You may develop a small lump in your groin which may last up to 6 weeks.

If you experience any significant bleeding, lie down, press firmly over the wound site to stop the bleeding and go to your nearest A&E.

Please contact your GP if you experience any redness in the groin that is warm to touch.

Contact information

Chelsea and Westminster Hospital

Interventional Radiology Department

T: 020 3315 8570/8582