What is an endovascular stent?

An endovascular stent is a tube made of tissue supported by a metal mesh called a stent. It can be used for a variety of conditions involving blood vessels, but most commonly to repair an aneurysm (a weak spot in an artery).

What is the role of peripheral arterial angioplasty with stent graft?

Left untreated, an aneurysm can, over time, enlarge and eventually rupture, resulting in various health problems.

Peripheral arterial stent graft angioplasty is designed to prevent this. The stent graft clamps tightly to your artery both above and below the aneurysm. The graft is stronger than the weakened artery and allows blood to pass through it without pushing on the aneurysm, and the risk of the aneurysm rupturing is greatly reduced.

Doctors usually use endovascular stent grafting to treat abdominal aortic aneurysms and thoracic aortic aneurysms. This technique is used less often for aneurysms that are located in other parts of the body.

Why is peripheral arterial angioplasty with stent graft indicated?

Angioplasty is a modern, minimally invasive procedure for which surgeons use special technology and instruments to keep your safety and risks to a minimum.

Typically, following this procedure and with the help of endovascular treatments, your hospital stay is greatly reduced, your recovery time is much faster, your pain is less, and your risk of complications is much lower.

How does peripheral artery angioplasty with stent graft take place?

Before the procedure, you will receive a sedative and either regional or general anaesthesia, depending on the decision you make with your surgeon.

To reduce the risk of infection, the vascular surgery team will clean your skin and shave hair from the area where the incision will be made.

Then your surgeon will make an incision in the skin covering the femoral artery in your groin area. Your vascular surgeon will insert a guide wire into the femoral artery up to the aneurysm.

Using X-rays that appear as moving images on a screen, your vascular surgeon inserts a catheter over the guide wire. The catheter carries a compressed form of the graft so it can move through your blood vessels. When the graft has reached the site of the aneurysm, your doctor removes the catheter, leaving the graft in place. The graft expands to fit snugly against the walls of your artery.

How long does recovery take after peripheral artery angioplasty with stent graft?

Normally, after the stent graft placement procedure you will need to stay in hospital for two or three days, but recovery will start from day one. You will be able to eat, and the clinic team will encourage you to take a few steps. 
Once you leave the hospital, there are a few things to keep in mind:

• do not drive until you have been cleared by your doctor
• you can shower, but be careful not to wet your groin incisions until they are fully healed
• avoid lifting weights heavier than 5 kilograms for about 4 to 6 weeks after the procedure

After a period of 7 to 10 days, your doctor will recommend that you return for a check-up. During that check-up, your doctor will check the healing of your incisions and assess your general health.

Afterwards, you will need to return for check-ups one month, three months and six months after the peripheral arterial angioplasty with stent graft procedure. These check-ups are necessary for your doctor to make sure that the stent is still working smoothly and is in the correct location.

Thereafter, you will need to have annual medical visits, where your doctor will perform imaging tests to check the condition of the aneurysm.

Risks of peripheral arterial angioplasty with stent graft

The chances of complications following endovascular stent grafting increase in the following cases:

• if you have chronic renal failure (a kidney disease)
• if you have a non-invasive form of aneurysm
• if there are blockages in the arteries near the aneurysm
• if you have already had an abdominal aortic aneurysm repaired
• if you have heart or lung disease

Complications of peripheral angioplasty with stent graft

• Blood leakage around the graft
• Infection
• Graft displacement away from the intended site
• Graft fracture
• Blockage of blood flow through the graft

Endovascular grafts can sometimes leak blood through the areas where the graft components join or allow blood to leak back into the aneurysm sac through the small arteries feeding the aneurysm sac.

These leaks can occur even years after the procedure and can be dangerous if the aneurysm continues to enlarge.

Because problems with the graft or endoleak can occur even years after successful placement, it is important to follow the follow-up regimen recommended by your vascular surgeon.