Treatment for arterial insufficiency will depend on whether the condition is acute or chronic and which artery and body part are affected.
Angioplasty is a procedure to open arteries that are blocked or narrowed by plaque. It can be used in arteries throughout the body to restore blood flow.
Angioplasty is performed with either sedation to allow you to relax or while you’re asleep under general anesthesia. During the procedure, the doctor inserts a catheter into a blood vessel through a small incision in the arm or groin. The doctor then guides the catheter to the site of the blockage. A balloon at the tip of the catheter then inflates, compressing the plaque against the artery wall.
In many cases, doctors use a small metal mesh tube called a stent, which is placed through the catheter. Once inside the artery, the stent helps keep it open to improve blood flow. The stent may be coated in a medicine that helps prevent the artery from narrowing again.
After angioplasty, you’ll remain at the hospital for at least a few hours, possibly overnight. Your doctor may prescribe blood thinners to prevent additional clots. You can usually resume normal activities within a week. Your doctor will guide you on how often you will need follow-up visits to check that the angioplasty is working well and the stent, if you have one, is still in place.
An atherectomy is a catheter-based procedure used to remove plaque buildup in the arteries. During an atherectomy, a medical provider will use a blade, a spinning tool or a laser to cut away or destroy plaque and restore blood flow.
Atherectomy is performed under local anesthesia with mild sedation. A catheter (small tube) will be inserted into the artery and guided to the spot of the blockage. Once in place, a tool at the end of the catheter will be used to remove or destroy plaque.
Following the procedure, you will need to lie flat for up to six hours to prevent bleeding. During this time, your vital signs will be carefully monitored. Because atherectomy is an outpatient procedure, most patients are released from the hospital on the same day as the procedure.
Vascular bypass surgery creates a new path for blood to flow around a blocked or damaged artery. For this procedure, doctors use either a synthetic graft or a healthy vein from another part of your body. They locate the area of the blockage and then sew the graft above and below the blocked artery section. The blood is then rerouted through the graft.
After bypass surgery, you will stay in the hospital for a few days. After that, you may need to regain your strength and mobility with outpatient rehabilitation. Your doctor will let you know when to return to the office for a follow-up visit to have your stitches removed.
Carotid endarterectomy is a surgery that allows doctors to remove plaque buildup from the carotid artery. This surgery can help reduce your risk for a stroke and restore normal blood flow to the brain.
Carotid endarterectomy is performed while you are under general or local anesthesia. Your surgeon makes an incision over the carotid artery and locates the plaque-filled area. A clamp temporarily stops the blood, which allows your doctor to carefully remove the plaque buildup from the inner lining of the artery. The artery is then sewn back together, and the clamp is removed.
After carotid endarterectomy, you may spend one night in the hospital and then you can typically resume normal activity within a few weeks. You’ll visit your surgeon to have your stitches removed, and they’ll check to make sure there are no complications.
Carotid stenting is a procedure to address plaque buildup in the carotid arteries in the neck. It is usually performed with sedation to help you relax or general anesthesia so you’re asleep. During this procedure, a catheter is inserted into a small incision at the top of the leg. The catheter is guided to the blocked carotid artery, and a balloon on the end of the catheter is inflated to push the plaque to the side. In most cases, a mesh tube called a stent is placed inside the artery to keep it open.
After carotid stenting, you may need to remain in the hospital overnight before returning home. In most cases, you will be limited to light activity for about a week.
- Aspirin therapy: In some patients, over-the-counter aspirin can thin the blood and reduce the risk for clots that can cause heart attacks or strokes. You should only use daily aspirin therapy if it is recommended by your doctor.
- Blood pressure medicines: Also known as antihypertensives, blood pressure medicines are prescription drugs that help lower high blood pressure. Many types of blood pressure medicines are available. They can reduce blood pressure by:
- Lowering the heart rate
- Reducing blood output
- Removing excess water and sodium from the body
- Relaxing the blood vessels
- Helping blood vessels dilate
- Blood-thinning medicines (anticoagulants): This type of medicine helps prevent blood clots from developing.
- Cholesterol medicines: These medicines help lower cholesterol in your blood by:
- Reducing the liver’s production of cholesterol
- Lowering the amount of cholesterol absorbed from food
- Lowering triglycerides
- Increasing high-density lipoprotein (the “good” cholesterol)
Thrombectomy is a procedure that directly removes a blood clot from a blocked blood vessel. Thrombectomy can be performed in two ways:
- During surgical thrombectomy, the doctor makes an incision at the site of the blockage to remove the clot and repair the blood vessel. Surgical thrombectomy is often performed if the clot is large or the blockage is in an area that is difficult to reach with catheters.
- In endovascular thrombectomy, also known as catheter-directed thrombectomy, a catheter is introduced into your artery through a small incision in the groin or arm. Once the catheter reaches the clot, doctors use special tools to remove it. Then, clot-dissolving medicine is used to clear away any remaining pieces.
After thrombectomy, you may be in the hospital overnight or for a few days, depending on the type of procedure you had.
Thrombolysis, also known as clot-busting therapy, is a procedure that uses medicine to dissolve blood clots within the blood vessels. Thrombolytic medicines are either injected straight into a vein or delivered through a catheter inserted into an artery near the clot location. During catheter-based thrombolysis, you receive local anesthesia so you don’t feel the incision for the catheter. If you receive systemic thrombolysis, you’ll receive the medicine through an IV. After thrombolysis, you’ll usually be monitored in the hospital for a few days. After you leave the hospital, you may need to follow up with your doctor to monitor your health and prevent additional clots.
