Angioplasty and Stenting

In some instances the vessels, arteries, or veins of an organ, such as the liver, may be blocked by an atheromatous plaque or fresh clot, depriving the organ of the blood supply. This situation most commonly encountered in transplanted livers or in elderly patients with diffuse vascular disease (heart, lower extremities, etc.), is translated by organ dysfunction, acute or recurrent pain.

When fresh clots are the cause of the clogged vessel, infusion of a clot buster drug may be necessary to break down the clots and to open up the vessel to reestablish the blood flow. When the narrowing or blockage is a more chronic process, balloon angioplasty is usually the first choice. For instance, patients with a blockage in the blood flow to their bowel can get abdominal pain, just as patients with blockage in their heart arteries get chest pain.

Opening up the arteries with a balloon can cure or improve these symptoms. Placement of metallic stents may also be necessary to keep the vessel open. If the balloon angioplasty is not successful to keep the vessel wide open and with good blood flow a metallic stent can be placed inside the vessel to support the walls of the vessel and preventing obstruction.

Rare but serious complications of balloon angioplasty are rupture of the vessel causing intra-abdominal bleeding, and further vessel blockage, that may require surgical correction. Most of the time, however, some other type of transcatheter treatment, such as stent placement, drug infusion or embolization, may be able to take care of the problem.