Angioplasty is a treatment for deep vein thrombosis (DVT), which is a blood clot that forms in one of the deep veins typically in your legs. DVT can partly or totally block the blood flow back to your heart and also damage your vein. Angioplasty helps to open up the blocked blood vessel and restore blood flow through it.
Anticoagulant medicines, also known as blood thinners, are the main treatment for DVT. These medicines don't really thin your blood. They stop the clot from growing and prevent new clots from forming. But if the clot is large, you may need more than blood thinners to treat it.
Up to 50% of people with DVT develop a complication called post-thrombotic syndrome (PTS), even if they take blood thinners. PTS causes long-term pain, skin sores, and swelling.
A clot can also break free and travel to the lung. That's called a pulmonary embolism (PE), and it can be life-threatening if it blocks the blood flow in your lung.
Angioplasty can be an option if blood thinners haven't relieved your DVT symptoms or if you have complications from the clot.
What Is Angioplasty?
Angioplasty is a minimally invasive procedure to widen narrowed or blocked blood vessels and improve blood flow. It's a common treatment for people with coronary artery disease whose blood vessels are narrowed by sticky deposits called plaques.
Angioplasty is also becoming a more common treatment for DVT because it helps to relieve symptoms and prevent complications like PE and PTS.
Why would you get angioplasty?
Angioplasty can be done with or instead of blood thinners to treat DVT and prevent complications. It helps to open up narrowed blood vessels, relieve DVT symptoms, and protect the vein from getting damaged.
You might need this procedure if you still have symptoms after taking blood thinners. Here are some other reasons why your doctor might recommend angioplasty:
- You have a very large clot.
- The DVT is blocking a major vein.
- You still have symptoms like pain and swelling after taking blood thinners.
- You're at risk for a PE or PTS.
How It's Done
A heart specialist called an interventional cardiologist or a vascular surgeon performs angioplasty. Your doctor will tell you how to prepare. You may need to stop taking blood thinners and other medicines before the procedure.
You'll get a contrast dye injected into one of your veins before and during the procedure. The dye highlights blood flow through your vein on an X-ray to help your doctor find the blockage. You'll also get medicine to relax you and prevent pain.
First, the doctor makes a small cut in the skin of your groin or behind your knee, depending on where the clot is located. Then they insert a thin, flexible tube called a catheter through that opening. The doctor places the catheter into the blocked blood vessel and uses a wire to guide it to the clot.
At the end of the catheter is a deflated balloon. Once the catheter is inside the vein, the doctor inflates the balloon. The balloon pushes through the clot to break it open and widen the blocked area. Once the vein is open, the doctor deflates the balloon and removes the catheter.
If the clot is large or balloon angioplasty can't remove it, you might also have stenting done. A stent is a small metal mesh tube your doctor places inside the blocked vein. The stent stays inside your vein to keep it propped open.
Your doctor might also place a filter into the inferior vena cava (IVC), a large vein in your belly that sends blood from your lower body to your heart. This filter will catch any blood clots that break free from your leg vein before they can travel to your lungs or heart.
Recovery
You might go home the same day as the procedure or stay in the hospital for a day or more after angioplasty. Your doctor will let you know what to expect.
Taking blood thinners after angioplasty can help prevent another blood clot. You may keep taking these medicines long-term. Your doctor will let you know how long you should stay on a blood thinner.
You might also wear compression stockings after angioplasty. These snug-fitting socks gently squeeze your legs to improve blood flow and prevent a new clot from forming.
You'll have follow-up appointments with your doctor to check your progress. Imaging tests like venograms can show how well blood is flowing through your leg veins.
Success Rate
Having a stent placed after angioplasty may lead to a better outcome. The success rate after angioplasty with stent placement ranges from 94 to 96 percent. In studies, most people who had this procedure had less pain and swelling and better wound healing afterward. In most cases, the vein was still open 1 year after the procedure.
Complications
Although complications from angioplasty are rare, the procedure can have risks like these:
- Bleeding
- Infection
- Damage to the vein
- Reaction to the anesthesia
- PE from pieces of the clot getting loose and traveling to the lungs
Call your doctor if you have symptoms like these after angioplasty:
- Swelling or pain that gets worse
- Bleeding
- Fluid or blood leaking from the surgery site
- Pain, weakness, or numbness in the area
Call 911 if you have any of these symptoms:
- Chest pain
- Shortness of breath
- Hard, fast, or fluttering heartbeat (called palpitations)
- Coughing up blood