Peripheral Angioplasty & Stenting

Endovascular Techniques

• Balloon angioplasty (PTA) — inflating a balloon catheter to open a narrowed arterial segment
• Drug-coated balloon (DCB) angioplasty — delivers antiproliferative medication to reduce restenosis
• Stenting — permanent metal scaffold for flow-limiting dissections or recoil
• Atherectomy — directional or orbital plaque removal before angioplasty
• Subintimal angioplasty and re-entry techniques for chronic total occlusions

Lesion Assessment & Classification

Disease is classified using the TASC II (Trans-Atlantic Inter-Society Consensus) framework, stratifying lesions by location, length, and complexity. Femoral-popliteal disease, aorto-iliac occlusions, and infrapopliteal disease require distinct endovascular strategies.

When Intervention Is Indicated

Supervised exercise therapy is evidence-based first-line treatment for stable claudication. Endovascular intervention is appropriate when symptoms significantly limit quality of life despite exercise therapy, when critical limb ischaemia is present, or when non-healing wounds require urgent revascularisation.

Critical Limb Ischaemia

CLI requires a multidisciplinary approach integrating vascular intervention, wound management, podiatry, and metabolic optimisation — particularly for diabetic patients with infrapopliteal disease where limb salvage is the primary goal.

After the Procedure

• Antiplatelet therapy continued long-term
• ABI measurement at follow-up to confirm haemodynamic improvement
• Duplex ultrasound surveillance at 1, 6, and 12 months
• Ongoing cardiovascular risk factor optimisation