peripheral vascular stent insertion
A peripheral vascular stent is a small tube made up of a metal that keeps the artery in the arm or leg open.

A peripheral vascular stent is a small tube made up of a metal that keeps the artery in the arm or leg open.

It is often placed in the artery after a procedure called peripheral artery angioplasty. This surgery involves widening the narrowed arteries of the arm or leg.

When is peripheral vascular stent insertion needed?

The doctor may suggest peripheral vascular stent insertion along with angioplasty when you have peripheral artery disease (PAD), which is a condition in which the arteries that supply blood to your limbs are narrowed, usually because of atherosclerosis. Atherosclerosis refers to the buildup of plaque (cholesterol and other substances) in the walls of the arteries.

The doctor may advise a peripheral vascular stent if you have:

  • Severe, debilitating leg pain, or heaviness that increases on walking (claudication)
  • Severe, debilitating arm pain, or heaviness that increases on using the arm (claudication)
  • Severe limb or arm pain that interferes with your daily functioning
  • Severe limb or arm pain that does not respond to lifestyle modification and exercise regimen
  • Lack of oxygen (ischemia) to the limb or arm with rest pain
  • Ischemic nonhealing ulcers of the limb
  • Non-resolving infection or gangrene in the limb
  • Dizziness (if PAD of the upper arm)

What is done before the peripheral vascular stent insertion procedure?

  • Tell the doctor if you are taking blood-thinning medications, such as aspirin, clopidogrel, warfarin, and pain medications, such as ibuprofen and naproxen, two weeks before the surgery.
  • Your doctor will ask you if you have any allergies.
  • Let your doctor know if you are or think you are pregnant or have any underlying conditions, such as diabetes or high blood pressure.
  • If you are into drinking or smoking, they may ask you to avoid them for a few days before the surgery.
  • Let your doctor know about any cold, flu, fever, or other illness you may have before your surgery. Surgery may get postponed in case of infections.
  • You will likely be asked not to drink or eat anything for several hours before the surgery. Only a few drugs as advised by the doctor can be taken with a small sip of water.

How is peripheral vascular stent insertion done?

Your doctor will inject certain intravenous medications to minimize the pain or discomfort during the surgery. You will remain awake during the procedure.

  • They will insert a thin, flexible tube called a catheter into an artery of your problematic leg or arm.
  • They will then inject a dye into your artery via that stent, which will highlight the blockages in the artery that have narrowed it.

The doctor then proceeds to do an angioplasty.

  • To perform this, the doctor uses a catheter with a balloon at the tip.
  • The doctor then moves the catheter with the balloon at the blockage and then inflates it so that there is more room for the blood to flow.
  • Then a stent (peripheral vascular stent) is inserted to keep the artery open, which can also keep small pieces of plaque from breaking off and causing problems.

What happens after the placement of the peripheral vascular stent?

A pressure bandage will be applied to the site of catheter insertion to prevent the area from bleeding. The area will be monitored for any signs of bleeding.

Your vitals, such as pulse, blood pressure, and temperature, will be monitored for several hours after the procedure.

You will need to keep your leg straight and sit still for the entire day. A bag containing weights may be attached to your leg to keep it from moving.

You may have to stay for one or two days in the hospital. After you get discharged, you can most likely return to normal activities.

What are the possible risks of the peripheral vascular stent insertion procedure?

Most of the complications, if any, may result from the site where the catheter was inserted and include:

  • Pain, swelling, and tenderness
  • Irritation and swelling of the vein (superficial thrombophlebitis)
  • Bleeding
  • A bruise (goes away in a few days)
  • Infection

Serious complications are rare and may include:

  • Sudden narrowing of the artery
  • Blood clots
  • Injury to the inner lining of the artery
  • An allergic reaction to the dye
  • Misplacement of the stent
  • Damage to the adjacent nerve
  • Kidney damage (due to the contrast)
  • Stroke
  • Heart attack

How long does a peripheral vascular stent last?

After insertion, a peripheral vascular stent will usually last for a lifetime. There is just a minor chance that the stent will fail, but it occurs usually within six months. Even if it happens, do not worry; the old stent can be replaced with a new stent.

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Medically Reviewed on 2/2/2022
References
Image Source: iStock Images

Mueller DK. Peripheral Vascular Stent Insertion. Medscape. https://emedicine.medscape.com/article/1839716-overview#