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Home » Services » ACI Cath Lab » Interventional Radiology » Peripheral Interventions

Peripheral Interventions

Cath labs are commonly used to investigate the blood supply to the legs and lower body and in particular to look for blockages of the leg’s blood supply, a condition called peripheral artery disease.

Peripheral Artery Disease (PAD) is a common condition that often goes untreated until it’s too late. It usually affects persons over the age of 50 and is extremely common in patients with diabetes. It is caused by the build-up of cholesterol and scar tissue inside of the blood vessels, a process called atherosclerosis, which is also responsible for heart disease and stroke in other parts of the body. The most common symptoms of early peripheral artery disease as defined by the American Heart Association is leg pain described as a painful cramping of the hips, thighs or calves when walking, climbing stairs or exercising. In the early stage of the disease, this pain will usually go away when you have stopped exercising. In the later stages and more severe stages of the disease the symptoms are:

  • Leg pain that doesn’t go away when you stop exercising
  • Foot or toe wounds that won’t heal or heal very slowly
  • Gangrene
  • A marked decrease in the temperature of your lower leg or foot particularly compared to the other leg or to the rest of your body.

It is important to know that the pain associated with peripheral artery disease is in the muscles and not the joints. Often this pain is considered a normal sign of aging and dismissed but this is not so. Peripheral artery disease is a serious but treatable condition. If the disease is left untreated, persons can lose their limbs. We therefore strongly advise persons experiencing these symptoms to see their doctor and describe as clearly as possible the symptoms they are experiencing. For more information please call our office and ask for our head nurse who will schedule an appointment for you to see a PAD specialist and have the necessary tests performed.

PAD is usually first diagnosed simply by looking for weak pulses in the legs and by taking blood pressures in the arms and the legs and making comparisons to derive a measure called the ankle-brachial index (ABI). Further testing can then be done as necessary using ultrasound, CT scans and MRI scans to get images of the blood supply to the legs. Once it is determined that treatment is required, the doctor will then refer the patient to have a peripheral angiogram in a cath lab and in some cases treatment can be done at the same time by a technique called peripheral angioplasty. In other instances treatment may be done by surgery.

Peripheral Angiography is a special angiogram looking at the blood supply to the legs. As described earlier, a thin plastic tube called a catheter is inserted into a blood vessel in the groin area through a small puncture in the skin. The catheter is then guided using X-rays to the blood supply of the legs and a special X-ray dye is injected into the blood vessel. Sophisticated X-ray movie pictures are taken as dye travels through the vessels from the top to the bottom of the leg. Once completed, the peripheral angiogram gives a detailed picture of all of the blood vessels in the leg clearly showing any blockages that might be present and their exact location.

In some instances the doctors may advise that the best treatment for the blockages is a technique called peripheral angioplasty. This technique is very similar to interventional techniques used to open blockages in the blood supply to the heart. In peripheral angioplasty once the area of the blockage has been identified then another catheter is carefully advanced under X-ray guidance to the blockage. At the tip of this second catheter is a balloon. This balloon is inflated once in position, in order to reopen the area of the blockage. The result is the restoration of the blood supply and the catheters are removed. The patient usually leaves the hospital on the same day of the procedure and the recovery is very quick.

While not as common, the same techniques described above can be applied to blockages in the blood supply to the arms once the condition is diagnosed.

Renal Angiogram and Angioplasty

The same principles outlined in the diagnosis and treatment of peripheral artery disease can be applied to the treatment of a condition called renal artery stenosis.

Renal artery stenosis describes a condition in which the blood supply to one of the kidneys is blocked or narrowed.

When referred to a cath lab for the treatment of renal artery stenosis, the first step is the performance of a renal angiogram to get a detailed picture of the blood supply to the kidney.

Once the blockage has been located on the angiogram, renal angioplasty may be performed using a balloon catheter, as described earlier, whereby the deflated balloon is carefully positioned at the point of the blockage and is then inflated to re-open the blocked artery.

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