What Is a Peripheral Vascular Stent? Peripheral Vascular Disease (PVD)

Before the procedure

• General anesthesia may be administered, or an intravenous (IV) sedation may be used to make you comfortable during the procedure.
• Local anesthetic may be applied to numb the area. While under local anesthesia, you may feel pressure, but you should not feel any pain or discomfort.

During the procedure

• A catheter is inserted into a blood vessel in your groin, arm, or wrist.
• A wire is inserted into the blocked artery through the catheter.
• Contrast liquid may be injected into the artery to help the doctor view it more clearly on the X-ray.
• A balloon is to open the artery.
• A stent is placed to keep the artery open.
• The catheter and wire are removed, and the wound is closed with stitches.
• Pressure is applied to the wound for several minutes to stop any bleeding.
• A pressure bandage may be placed over the wound to help prevent bleeding.

After the procedure

• Doctors will monitor your vital signs and pulses in your arm or leg. Your pressure bandage will be checked for bleeding or swelling.
• You will need to lie flat with your leg or arm straight for 2-4 hours.

Possible risks of a peripheral vascular stent implant include:

• Bleeding
• Infection
• Bruising
• Pain
• Blood clots, which can lead to heart attack or stroke
• Kidney damage or an allergic reaction due to the contrast liquid

Peripheral vascular disease (PVD) or peripheral artery disease causes constriction and hardening of the arteries, which leads to reduced blood flow that can harm the tissues supplied by the narrowed or blocked artery. 

When plaque builds up on the walls of the arteries, it causes them to constrict and harden, making it impossible for them to expand to pump blood where needed. There are two types of PVD:

• Functional PVD
  • Occurs when there is no physical damage to the blood vessel structure
  • The arteries spasm in reaction to stimuli, such as temperature changes or brain messages
  • Blood flow decreases due to vessel narrowing
  • Common causes of functional PVD include:
    • Stress
    • Cold temperatures
    • Drugs
    • Operating machinery or tools that vibrate
• Organic PVD
  • Caused by blood vessel structural alterations such as inflammation, plaque, and tissue destruction
  • Common causes and risks of organic PVD:
    • Smoking
    • High blood pressure
    • High cholesterol
    • Blood clots
    • Infection
    • Diabetes
    • Injury to the arms and legs
    • Coronary artery disease
    • Men over 50
    • Kidney disease involving hemodialysis
    • Stroke

Peripheral vascular disease (PVD) affects about 8 million people in the United States and more than 200 million people globally. According to the Centers for Disease Control and Prevention, PVD affects 12%-20% of Americans over age 60.

Symptoms of PVD include:

• Pain
• Fatigue
• Burning or discomfort of your feet, calves, or thighs
• Numbness in your legs when you are at rest
• Legs may feel cool to the touch, and the skin may appear pale
• Pain or tingling in the feet or toes that is worse at night
• Pain that is worse when you raise the leg and improves when you dangle your legs over the side of the bed
• Sores that do not heal
• Decreased blood pressure in the affected limb
• Loss of hair on the legs or feet
• Weak or absent pulses in the limb
• Shrinking calf muscles
• Impotence
• Thick toenails

Early peripheral vascular disease treatment can help you regain mobility and reduce the risk of heart attack, stroke, and amputation. While you cannot avoid certain risk factors for PVD, you can adopt lifestyle changes that can greatly reduce your risk:

• Lifestyle modifications
  • Balancing exercises
  • Walking or doing another activity to the point of pain and alternating it with rest periods
  • Smoking cessation
  • Controlling your blood pressure
  • Losing weight if you are overweight
  • Lowering your cholesterol
  • Controlling your blood sugar levels if you have diabetes
• Medications
  • Blood thinners to keep your blood from forming clots in your arteries
  • Medications to widen the affected artery or arteries in moderate-to-severe cases that do not need surgery
  • Medications to help lower your cholesterol
  • Pain relievers
• Surgical intervention
  • Vascular surgeons can restore blood flow to relieve pain, improve quality of life, and avoid serious health risks by using precise imaging technology and minimally invasive endovascular techniques (procedures performed with tools at the end of long thin flexible wires inside the vessels).
  • A balloon attached to the tip of a catheter (balloon angioplasty) can drive the blockage open, and a mesh tube (stent) can keep it open.
  • Vascular surgeons can employ natural or synthetic channels to bypass constricted arteries in the legs, abdomen, or pelvis.
  • Atherectomy (plaque removal surgery), drug-eluting stents, and clot-catching filters can help open up the arteries.