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Preparing for a Percutaneous Transluminal Angioplasty (PTA)



Your primary doctor has scheduled a percutaneous transluminal angioplasty to be done by our Interventional Radiologists on _________ at _________AM/PM.  This handout explains the procedure to you, and tells you how to prepare for it and what to expect after.  Before the angioplasty, our doctors will explain the procedure and ask for your consent to do it.

 

What Is a Percutaneous Transluminal Angioplasty (PTA)?

 

A PTA is a series of x-ray pictures taken with the use of contrast (x-ray dye).  Arteries or veins that have been narrowed or blocked are opened using a balloon.  A special catheter with a balloon on the tip will inflate and deflate to open a blocked vessel in your body.  Before it is done, an arteriogram is always done to help the doctors see the arteries in the precise part of the body.


Why Do You Need a Percutaneous Transluminal Angioplasty?

  • An MRA or arteriogram has shown that an artery is narrowed or blocked.
  • It is the best method for the patient who should not have surgery for certain reasons.
  • Most of the time it is the preferred method to open blocked vessels that are easy to reach.


How to Prepare for the Angioplasty

 

  • We will draw blood work the morning of the procedure.

 

  • If you are taking any blood thinners such as aspirin, Persantin, warfarin (Coumadin®) or clopidogrel (Plavix®) you will be told whether to stop these medicines before the procedure.

 

  • Do not eat 6 hours before your procedure.  You may have clear liquids up until 4 hours before your procedure.

 

  • If you have diabetes and take insulin, we will tell you what to do to manage your blood sugars before the procedure.

 

  • Take your prescribed oral medicine as scheduled with a few sips of water.

 

  • If there is any chance you might be pregnant, please tell the radiologist.

 

  • Be sure to tell the radiologist if you have any allergies to contrast dyes, antibiotics, anesthetic agents, or any other medicines that you may have taken before.

 

  • Tell the radiologist if you are allergic to iodine or latex.

 

  • Please make plans to have someone drive you home after the angioplasty.

 

  • If you are on a medicine called Glucophage, tell your primary doctor and/or the radiologist.

 

The Procedure


 

The procedure is done in the Radiology Department in our Angio-Interventional Suite.  Again, be sure to tell the radiologist if you have any allergies to contrast dyes, antibiotics, anesthetic agents, latex, iodine, or any medicines that you may have taken before.

 

Most of the time, the procedure takes an hour, sometimes longer.  An intravenous (IV) catheter will be started to give you fluids.  You may be given medicine to relax you.

 

A nurse will check your vital signs with a blood pressure cuff and a pulse oximeter (a plastic clip on your finger that checks your oxygen level).  After the doctor finds your femoral artery and marks it, that area of the groin will be shaved and cleaned.  You will then be covered with sterile drapes to help prevent infection.  The doctors will wear sterile gowns and masks to provide a clean setting.

 

The skin at the entry site will be numbed with lidocaine so you will have little pain during the procedure.  Most patients do not feel a lot of pain.  You will feel pressure during the catheter placement.  Under fluoroscopy guidance, a small catheter is placed in the femoral artery.  The radiologist will advance the catheter into the place that needs to be studied.

 

The small catheter will be hooked up to an injector at which time the “contrast” or dye injects into the artery.  You may have a feeling of warmth or heat at this time.  This is normal.  It is often felt in the abdomen and buttocks.  The contrast or dye highlights the vessels being studied.  You will be asked to hold your breath so you do not move while the films are being taken.  These injections through the catheter will be done a few times.

 

After finding the place and size of the blockage, the angioplasty will begin.  The catheter is threaded up until it reaches the blocked area.  At the end of the catheter is a balloon.  The balloon catheter inflates for 15-60 seconds and then deflates.  It will inflate and deflate several times.  You may have a feeling of pressure at the site where the balloon inflates.  Some patients have a fair amount of pain where the balloon inflates.  If this happens, you will be given IV pain medicine.  After the angioplasty, another arteriogram is done to see if the angioplasty has been a success and if blood flow has been improved.  It is common for the peripheral pulses to improve right away, lower arm or leg color is improved, and you may have less pain.

 

 

 

 

 

After the Procedure
 

When it is done, you will return to a nursing care unit on a cart.

 

  • You will need to lie flat with your leg straight for 4-6 hours.
  • Vital signs such as blood pressure, pulse, and temperature will be taken often.
  • Circulation checks of your leg will be done with vital signs.
  • The groin site will be checked for bleeding and hematoma.
  • You may eat and drink what you’d like.
  • You may start taking all your prescribed medicines as scheduled.
  • To make it easier for you, you may have urine catheter in place while you are lying flat.  This is placed in your bladder to keep it emptied so you do not have to use a bed pan or a urinal.
  • You will have an IV to give you fluids.


Home Care after Your Angioplasty


Before you go home

 

  • The nurse or doctor will show you how to apply direct pressure to the site in case it bleeds.
  • Write down the date the doctor says you can return to work.
  • Write down the date the doctor says you can resume driving (often 48 hours after the procedure).
  • Write down the date the doctor says you may resume taking your anticoagulants or blood thinner medicine.


What to do when you are home

 

  • If bleeding occurs at the site, apply direct pressure and go to the nearest emergency room.

 

  • Keep the gauze dressing dry for 24 hours.  After that, you can remove the gauze dressing and shower or bathe as you’d like.  Put a bandaid over the site for the next 3 days.

 

  • Drink at least 10-20 glasses of fluid (water, coffee, juice, tea, any food that melts at room temperature, etc) for the first 24 hours.  Do not drink alcohol the first day.

 

  • Keep your leg (with the puncture site) straight when sitting or lying down for the first 24 hours.

 

  • No heavy lifting (more than 10 pounds) for 24 hours.

 

  • Puncture Site - once a day for five (5) days, look at puncture site on your leg for signs of infection.  Call your doctor if you notice any of these signs:
    • red and/or hot puncture site
    • foul-smelling, yellowish or greenish drainage from puncture site
    • increased swelling at puncture site
    • temperature (by mouth) above 100°F or 37.8°C.

 

  • If you feel very dizzy, faint or light-headed, this may be due to low blood pressure, and you may be bleeding internally.  If you feel this way, go to the nearest emergency room.

 

Pain Medicine


You should feel only a little pain after you are home.  For relief, take acetaminophen (such as Tylenol®).  Do not take aspirin.  It may cause bleeding.


When to Call Your Doctor


Call your doctor if any of these happen

  • Signs of infection
  • Large bruise under and around the puncture site (often firm to touch)
  • Severe pain or spasms in the leg
  • Numbness and/or tingling in foot or leg
  • Loss of motion in foot or leg
  • Itching or hives anywhere on your body
  • Vomiting

Phone Numbers


If you have any questions or problems once you are at home, call the Radiology Department (608) 263-8355 during the day (7:30 am to 4:00 pm).

 

Nights, weekends and holidays, this number will give you the paging operator.  Ask for the Angio/Interventional Radiologyresident on-call.  Give your name and phone number with the area code.  The doctor will call you back.


If you are calling from out of the area, 1-800-323-8942.



The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 07/30/2010

Copyright © 07/30/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #4642

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