Peripheral Artery & Vein Intervention

What is a Peripheral Artery & Vein Intervention?

Peripheral Artery & Vein Intervention is a minimally invasive procedure aimed at treating peripheral vascular diseases affecting blood vessels outside of the heart and brain. These interventions are designed to open narrowed arteries and veins, improving blood flow. Techniques may include angioplasty, where a balloon is inflated to open the vessel, stenting to keep the vessel open, atherectomy to remove plaque, and thrombolysis for dissolving blood clots.

Why is the Procedure Performed?

The primary goal of these interventions is to alleviate symptoms of Peripheral Artery Disease (PAD) and other vascular conditions, such as leg pain while walking (claudication), non-healing wounds, and to reduce the risk of limb amputation. It is also performed for deep vein thrombosis (DVT) and other venous disorders to improve blood flow and reduce symptoms like swelling and pain.

How is the Procedure Performed?

• Access: The procedure is typically performed under local anesthesia with sedation. Access to the affected artery or vein is usually gained through a small puncture in the groin or arm.
• Imaging: Fluoroscopy, a type of X-ray imaging, guides the catheter to the correct location.
• Intervention: Depending on the condition, various tools can be passed through the catheter to open the narrowed or blocked vessel. This may involve inflating a balloon (angioplasty), placing a stent, removing plaque (atherectomy), or breaking up a clot (thrombolysis).
• Closure: The puncture site may be closed with manual pressure, a closure device, or sutures, depending on the size of the access site.

What are the Risks and Benefits of the Procedure?

• Benefits:
  • Improved blood flow and reduced symptoms of Peripheral Artery Disease (PAD) and venous disorders.
  • Decreased risk of complications associated with poor circulation, such as limb loss.
  • Faster recovery and less pain compared to open surgical procedures.
• Risks:
  • As with any minimally invasive procedure, there are risks including bleeding at the puncture site, infection, damage to the blood vessel, and rare chances of more serious complications like stroke, heart attack, or kidney damage from the contrast dye.
  • There is also a risk of restenosis (re-narrowing of the vessel) or stent migration over time.

Preparing for Peripheral Artery & Vein Intervention

What to Expect During the Procedure

• During the Procedure: You will be awake but will receive moderate and local sedation. Local anesthesia is applied to numb the insertion site. The procedure involves inserting a catheter into the peripheral artery or vein, often through the groin or arm. Depending on the type of intervention, such as angioplasty, stenting, and/or atherectomy, the procedure can last from 30 minutes to several hours.
• Imaging Guidance: Real-time X-ray imaging (fluoroscopy) is used to guide the catheter to the treatment site.
• Sensation: You might feel pressure at the insertion site or a warm sensation as the contrast dye is injected, but the procedure is generally not painful.

Pre-op Instructions

• Fasting: You will likely be asked to fast for 8 hours before the procedure.
• Medication Review: Inform your physician about all medications and supplements you are taking. Some medications may need to be adjusted or stopped, especially blood thinners.
• Preparation: Shower with antibacterial soap the night before or the morning of the procedure to minimize the risk of infection.

Medications to Avoid Before the Procedure

• Blood Thinner Medications: You may be asked to stop taking medications, such as blood-thinning medications a few days before the procedure to reduce the risk of bleeding. Do not stop any medications without first consulting your healthcare provider.
• Diabetic Medications: Instructions will be provided on how to adjust or stop insulin or oral hypoglycemics due to fasting.
• Other Medications: Inform your physician about all over-the-counter medications, supplements, and herbal treatments you are taking, as some may need to be paused.

What to Bring to the Surgery Center

• Photo ID and Medical Insurance Cards: Ensure you have identification and any necessary medical insurance information.
• List of Current Medications: Including dosages and frequency.
• Emergency Contact Information: Have the name and contact information of a family member or friend who can be reached if necessary. Please note: Someone will need to drive you home and stay with you for 24 hours after the procedure.

What to Expect After the Procedure

• Recovery Room: You will be monitored in the recovery room for a few hours to ensure there are no immediate complications, such as bleeding from the catheter insertion site.
• Discharge Instructions: You will receive specific instructions regarding care for the insertion site, activity restrictions, and medication adjustments before going home.

Post-op Instructions

Follow these post-procedure guidelines to plan your recovery:

• Driving Restriction: Do not drive for at least 24 hours after the procedure. Arrange for someone to drive you home from the procedure center.
• Activity Restrictions: You may be required to avoid strenuous activities or lifting heavy objects for up to seven days.
• Incision Care: Keep the insertion site clean and dry. Instructions will be given on how to care for the site and when you can shower.
• Medication: You may be prescribed new medications or continue with adjusted doses of existing medications. Follow these instructions carefully.

Recovery Tips

• Stay Hydrated: Drink plenty of fluids to help flush the contrast dye from your body unless otherwise directed by your physician.
• Monitor for Symptoms: Keep an eye on the catheter insertion site for signs of infection or excessive bleeding.
• Gradual Activity Resumption: Gradually increase your activity level based on your physician's recommendations.

When to Seek Medical Attention

• Infection Signs: Redness, swelling, increased pain, or discharge at the insertion site.
• Severe Pain: Any new or worsening pain in the treated limb.
• Changes in Limb Color or Temperature: If the limb becomes pale, blue, cold, or numb, seek immediate medical attention.

By understanding how to prepare and what to expect, you can approach your Peripheral Artery & Vein Intervention with confidence. Always follow the specific instructions provided by your healthcare team and communicate any concerns or questions you may have.