Revascularization
Revascularization is a procedure that can restore blood flow in blocked arteries or veins. For someone with peripheral artery disease (PAD), the operation can help ease symptoms and prevent serious complications.
The goals are to relieve pain, help you stay active, heal wounds related to lack of blood flow, save your limbs from amputation, and improve your day-to-day life.
What Conditions Does Revascularization Treat?
People with arteries that are so blocked that blood can’t travel to their legs and feet may benefit from a revascularization procedure. But it’s not for everyone. Whether it’s right for you depends on how bad your PAD symptoms are.
For example, a less severe form of PAD is called intermittent claudication, which involves leg pain during exercise that disappears when you rest. The first treatment is usually a rehabilitation program that involves physical activity. A doctor may also prescribe medicine and recommend you quit smoking before they consider revascularization if needed.
Ischemia — where the lack of blood flow has badly damaged leg and/or foot tissue — is more severe and requires prompt care. Its symptoms can include pain, ulcers, or gangrene. Without revascularization, you may lose all or part of your limb to amputation.
What Are Different Types of Revascularization Procedures?
Revascularization falls into two main categories: less-invasive interventional procedures and more-traditional surgeries.
There are two main types of interventional procedures, which usually happen while you’re still awake but with medicine to keep you comfortable.
Angioplasty: Your doctor uses a small balloon to open a blocked blood vessel. They start by making a small cut in your groin and inserting a catheter into an artery in your leg. Within the catheter, they then place a small balloon into the narrowed blood vessel and expand it.
Some people get a stent during angioplasty to help keep a blood vessel open after the balloon has been removed. Stents are metal mesh tubes that provide support inside the blood vessel. Some types release drugs over time to keep a blood vessel from narrowing again.
Atherectomy: Your doctor uses a catheter with a sharp tool attached to physically clear out the plaque that’s creating the blockage. It’s an option for blocked arteries in areas that are hard to reach with stents.
Some people need revascularization surgery, which happens under general anesthesia (when you get medicine to put you to sleep). There are two main types:
Bypass surgery: A vascular surgeon uses a graft of a blood vessel to reroute blood flow around a blockage.
Endarterectomy: A surgeon opens your artery to remove plaque buildup inside.
In some cases, doctors use a hybrid procedure that combines both a catheter-based intervention and open surgery.