Endovascular angioplasty and stenting of the arteries of lower extremities in case of stenotic lesion

This is an endovascular surgery for restoration and improvement of blood flow rate in the arteries of the lower extremities. It can be planned or urgent. Brachial, femoral or tibial arteries are used for arterial access depending on the level of damage and technical requirements of the surgical intervention.

A specialist of the clinic performs the treatment of arterial sclerotic, thrombotic, aneurysmatic lesions of arteries, femoral, popliteal, tibial arteries; we provide the assistance to difficult patients with critical lower limb ischemia, pancreatic diabetes, multifocal atherosclerosis, severe comorbidity. It is used both as antegrade and retrograde revascularization technique accompanied with the puncture of the tibial arteries in the opposite direction of the blood flow; hybrid surgeries with the application of the advantages of the open vascular surgery and the endovascular surgery at the same time are performed at our center.

The endovascular surgical intervention is performed in an operating room under local anesthesia and intravenous anesthesia (if needed). A surgical team (surgeon, surgical nurse) performs a correction of the arterial sclerotic lesion of the target vessel. The puncture of radial, brachial or common femoral artery is performed, and the selective cannulation of the target artery is performed using an endovascular conductor and a guiding catheter. The contrast-enhanced angiography of the vascular bed with the angiography of the atherosclerotic lesion of the artery is performed, methods of protection against distal embolization are applied if needed. Predilatation of the arterial sclerotic disease and stenting of the target artery is performed (if needed) according to “monorail” system. Post-dilatation (if indicated). Angiography with the recording of intervention results in various projections is performed. Surgical equipment is removed when the intervention is completed. The hemostasis of the vascular access is performed. Aseptic dressing.

Indications for the procedure: data of the clinical picture, ultrasound examination, CT angiography.

Service duration: 60 to 120 minutes.

Special aspects of service provision

The procedure has no age restrictions.

Contraindications for the procedure: allergic reactions to contrast agents, active infectious process.

Appointment for the surgical intervention is carried out only after a check-up by a specialist cardiac surgeon of Dobrobut clinic chain.

Preparation: mandatory preliminary consultation by an angiosurgeon before the surgery, pharmacological therapy remains unchanged if there have been no corrections by a cardiac surgeon. Discontinuation of metformin the day before and one day after angioplasty and stenting.

Limit the food intake 6 hours before the surgical intervention.

A patient should have the results of the following laboratory and instrumental diagnostic tests before he/she undergoes the surgical intervention*:

• blood type and Rh factor
• clinical blood test
• clinical urine test
• blood glucose
• total bilirubin, ALT, AST
• creatinine, urea
• coagulogram, lipid panel
• ECG, ultrasound examination of the vessels of the lower extremities