Peripheral Vascular Ablation

Peripheral vascular ablation uses a laser to clear or ablate blockages in your peripheral arteries and improve blood flow. It is performed to treat peripheral artery disease (PAD), which causes blockages in the arms, legs, neck, and abdomen.

The vascular specialists at UPMC use minimally invasive techniques, including ablation, to treat blocked arteries caused by peripheral artery disease (PAD).

What Is Peripheral Vascular Ablation?

Peripheral vascular ablation uses a laser to clear or ablate blockages in your peripheral arteries and improve blood flow. Peripheral vascular ablation is minimally invasive and performed by threading a laser catheter into your artery through a small incision, usually in your groin.

Conditions we treat with peripheral vascular ablation

• Peripheral artery disease (PAD).

Why Would I Need Peripheral Vascular Ablation?

You may need peripheral vascular ablation if you are diagnosed with PAD. PAD restricts blood flow through the vessels beyond your heart — usually in your arms, legs, neck, and abdomen.

Circulation disorders in these vessels, which carry oxygen and other nutrients to vital organs and tissues, are most often caused by atherosclerosis (also called hardening of the arteries), a progressive disease caused when plaque (composed of fat, cholesterol, and other substances) is deposited on the inner wall of your artery.

Over time, the inside of your artery will narrow (called stenosis), and blood flow through your artery is reduced or stopped. Plaque commonly forms in the iliac arteries in your lower abdomen and the femoral and popliteal arteries in your legs.

Who’s a candidate for peripheral vascular ablation?

You may be a candidate for peripheral vascular ablation if you have symptoms of PAD, including:

• Leg discomfort.
• Leg pain or cramping that develops with walking and is relieved at rest (intermittent claudication).
• Pain in the ball of the foot or toes while at rest.
• Non-healing ulcers on your feet or legs.

Alternatives to peripheral vascular ablation

• Medication
• Balloon angioplasty
• Atherectomy catheters.
• Leg bypass surgery.
• Amputation.

What Are the Risks and Complications of Peripheral Vascular Ablation?

Peripheral vascular ablation is a safe and well-tolerated procedure. However, like all medical procedures, it comes with risks, including:

• Allergic reactions.
• Bleeding.
• Blood clots.
• Infection at the incision site.
• Problems with your artery, such as re-narrowing or rupture.

What Should I Expect From Peripheral Vascular Ablation?

Before: How to prepare for peripheral vascular ablation

Your doctor will explain the peripheral vascular ablation procedure to you and answer your questions. To prepare for the procedure, you should:

• Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
• Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
• Tell your doctor if you have heart valve disease, as you may need to receive an antibiotic before the procedure.
• Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. You may need to stop some of the medications prior to the procedure.
• Fast for a certain time before the procedure. Your doctor will tell you how long to fast (usually overnight).
• Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.

On the day of your procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home. If you have a CPAP machine, please bring it with you.

You will need to stay in the hospital for 1-2 days after your procedure. You should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You should also arrange for someone to drive you home from the hospital after you are discharged.

How long does peripheral vascular ablation take?

Peripheral vascular ablation takes about an hour.

During your peripheral vascular ablation

You will be positioned on a table and will be given local anesthesia. You will be awake for your procedure but should not feel any discomfort. During your procedure:

• Your doctor will make a small incision in your groin or arm to insert the catheter. The catheter will be advanced into your peripheral artery.
• After the laser catheter is in place, it will emit ultraviolet light to remove the blockage by evaporating the plaque. Ultraviolet light is much cooler than infrared lasers, so it reduces the risk of damage to your surrounding tissue.
• If you have multiple blockages, the laser catheter will be moved from blockage to blockage.
• After all the blockages are ablated, the catheter will be removed and x-ray contrast dye will be injected into your blood vessel, allowing your doctor to evaluate the results of the procedure.
• Your doctor may also perform a procedure called balloon angioplasty to ensure the blockages in your arteries are completely cleared. During balloon angioplasty, your doctor will insert a special catheter with a balloon at the tip into your artery. When the catheter is in position, your doctor will inflate the balloon and push any remaining plaque aside to restore blood flow in your artery.

Recovery after peripheral vascular ablation

When the procedure is completed, you will be moved to recovery for observation and to address any issues you may have with pain. You will stay in the hospital for 1-2 days after the procedure.

You should ask your doctor when you can return to work and resume normal activities. It is very important that you see your doctor for follow-up visits as recommended.

When to call your doctor about peripheral vascular ablation complications

You should call your doctor if you are experiencing any unusual symptoms, including:

• Pain, redness, bleeding, drainage, or increased swelling at the insertion site.
• Chest pain or shortness of breath.
• Severe pain, coldness, numbness, swelling, or discoloration in the limb where the catheter was inserted.
• A fever of more than 100.0°F or chills.
• Fainting, dizziness, or weakness.

If any of these symptoms are severe, you should dial 911 immediately.

What’s the prognosis after peripheral vascular ablation?

For most patients, peripheral vascular ablation restores blood flow to your limbs and helps to reduce the risk of complications.

What’s the success rate of peripheral vascular ablation?

Peripheral vascular ablation successfully treats PAD in more than 90 percent of patients.

Why Choose UPMC for Peripheral Vascular Ablation?

· We are among the most experienced in the region in diagnosing and treating peripheral artery blockages using minimally invasive catheter-based techniques.

• A multidisciplinary team will provide you with comprehensive vascular and PAD care.
• Our specialists are also involved in clinical trials and offer the latest treatment options.
• We perform hundreds of interventional vascular procedures yearly in our state-of-the-art catheterization labs.

By UPMC Editorial Staff. Last reviewed on 2024-10-01.