Percutaneous Superficial Femoral Artery Angioplasty and Stenting Procedure

#interventionalradiology #interventionalradiologypills #IRadiology

Human #vascular system is responsible of blood supply to all of the body’s organs.
Over time, the arterial wall undergoes changes related to multiple factors:

Blood pressure
Exposure to toxic substances (cigarette smoke above all)
Metabolic diseases affecting the #cardiovascular system (#diabetes)

Alone or in combination, these factors determine a progressive deterioration of the intimal layer and the consequent formation of the #atherosclerotic #plaque.
In most cases, this process takes years or even never leads to vascular events. Sometimes the deterioration of the vascular system is rapid and leads to a #stenosis or #occlusion of the pathological vessels with the presentation of the Fontaine/Rutherford symptoms.

Fontaine
stage I: Asymptomatic
stage IIA: Mild claudication
stage IIB: Moderate-severe claudication
stage III: Ischemic rest pain
StageIV: Ulceration/gangrene

Rutherford
stage 0: Asymptomatic
stage 1: Mild claudication
stage 2: Moderate claudication
stage 3: Severe claudication
stage 4: Ischemic rest pain
stage 5: Minor tissue loss
stage 6: Ulceration/gangrene

The #endovascular treatment of atherosclerotic lesions is performed by the #interventional #radiologist and consists in the reopening or dilation to non-pathological calipers of the vessels affected by atherosclerotic disease. This mini-invasive and almost painless treatment is called percutaneous #angioplasty and is carried out by means of #balloons inflated with fluid at high pressure which causes a partial structural failure of the vessel wall with an increase in vessel diameter. Treatment-induced #barotrauma sometimes induces #dissection of the vessel. In other ones the effect of barotrauma is not sufficient to ensure a durable revascularization. In these cases, the release of a #stent promotes the resolution of dissection and helps to maintain the vessel patency.
The subsequent increase of blood flow downstream the site of treatment usually induces an improvement of sings and symptoms.

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