Angiogram: An angiogram is one of the best tools utilized by vascular surgeons to visualize blood flow in the arteries. An angiogram begins with a small, minimally invasive incision in the groin to access the leg artery. Next, a small needle is used to make a puncture in the femoral artery. A catheter (long, thin, flexible tube) is carefully guided into the artery and positioned at the area where plaque may be present. The surgeon then injects contrast dye through the catheter which is then visualized by x-ray machinery. This allows the surgeon to visualize the inside of the artery and determine the location and extent of arterial blockages and which kind of treatment is necessary. This is the first step of any minimally invasive treatment.
Angioplasty: When an arterial blockage is discovered, your surgeon may use balloon angioplasty to help widen the vessel. A wire is first guided across the area of plaque, and a small, deflated balloon is then placed in the area of narrowing in the artery. The surgeon then inflates the balloon to push the plaque up against the artery wall to widen the blood vessel. When the balloon is deflated, the blood vessel is now wider and able to allow more blood to pass through it. Contrast dye is then injected through the artery to confirm the results.
Stenting: Sometimes, an angioplasty is not sufficient to keep an artery open and a more permanent solution is necessary. A stent acts as a hollow, metal, scaffold by "propping open" an artery. A stent is guided to the area of the plaque in the artery with a catheter and is then deployed to push the plaque against the wall and increase the diameter of the artery. Stents are very flexible and are designed to twist and turn with body and artery movement.
Atherectomy: Instead of pushing plaque against the wall, the atherectomy procedure is used to mechanically remove plaque from the artery. First, A small, rotating burr is guided to the area of plaque with a catheter. The vascular surgeon then activates the burr which begins to rotate and break apart the plaque. The surgeon may need to do multiple passes of the plaque to "shave" the plaque off of the vessel wall. The burr is specially designed to only engage with plaque in the artery and it avoids damaging the vessel wall. Depending on the device used, the plaque particles are either sucked out of the artery or they are ground up into microscopic pieces and eliminated by the body's natural mechanisms.