“Angioplasty changed vascular surgery. What used to require a large incision and weeks of recovery can now often be done through a pinhole in the skin, with patients walking the same evening.”
Written by Dr Rahul Agarwal, Consultant Vascular & Endovascular Surgeon
CARE Hospitals, Banjara Hills, Hyderabad
Balloon angioplasty and stenting are among the most important tools in a modern vascular surgeon’s arsenal. Used to treat blocked or narrowed arteries in the legs, they restore blood flow without the need for open surgery in the majority of suitable patients.
🦠 What Is Angioplasty?
Angioplasty (PTA) is a procedure where a tiny balloon on a catheter is inflated inside a narrowed artery to stretch it open. The entire procedure is done from a small skin puncture under X-ray guidance — no open incision required.
🦧 What Is Stenting?
A stent is an expandable metal mesh tube deployed after balloon angioplasty to keep the artery open. Not every angioplasty needs a stent — the decision depends on artery location and the result of the balloon alone.
🏥 The Procedure — Step by Step
- Local anaesthetic at the puncture site (usually groin)
- Needle puncture of the artery, wire and catheter placed inside
- Contrast dye injected to map the blockage on X-ray
- Guidewire navigated through the blockage
- Balloon inflated at the narrowing; stent deployed if needed
- Final angiogram confirms result; catheter removed
Most procedures take 1–2 hours. Patients are awake and typically go home the next day.
📊 Arteries That Can Be Treated
- Iliac arteries (pelvis) — Excellent long-term results with stenting
- Superficial femoral artery (thigh) — Standard angioplasty ± drug-coated balloon
- Popliteal artery (knee)
- Tibial arteries (below knee) — Critical for diabetic foot limb salvage
❓ Frequently Asked Questions
How long does angioplasty last?
Iliac stents typically remain patent 5+ years. Superficial femoral angioplasty may need repeat treatment in 2–3 years. Drug-coated balloons significantly improve below-knee results.
Is angioplasty better than bypass?
Neither is universally better. Angioplasty is less invasive with faster recovery and is first-line for suitable lesions. Bypass provides more durable results for long complex occlusions. The right choice depends on your anatomy and overall fitness.
💡 Key Insight: In diabetic patients with foot wounds and blocked tibial arteries, below-knee angioplasty has transformed outcomes — turning what once meant amputation into a 90-minute catheter procedure that restores the foot’s blood supply directly.
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About the Author 🧑🏻⚕️
Dr Rahul Agarwal is a Consultant Vascular & Endovascular Surgeon at CARE Hospitals, Banjara Hills, Hyderabad.