Name of the Procedure:

• Common Name(s): Drug-Coated Balloon Angioplasty
• Technical Term: Catheter, transluminal angioplasty, drug-coated, non-laser (C2623)

Summary

Drug-coated balloon angioplasty is a minimally invasive procedure used to open narrowed or blocked blood vessels. A special balloon coated with medication is inflated at the site of the blockage to widen the vessel and deliver drugs that help prevent re-narrowing.

Purpose

• Medical Conditions: Used to treat peripheral artery disease (PAD) and other types of vascular obstructions.
• Goals: Improve blood flow, reduce symptoms like pain and cramping, and enhance overall vascular health.

Indications

• Specific Symptoms: Leg pain during walking (claudication), rest pain, non-healing wounds, or ulcers due to poor circulation.
• Patient Criteria: Patients with significant arterial blockages not responsive to lifestyle changes or medication.

Preparation

• Pre-Procedure Instructions: Patients may need to fast for several hours before the procedure. Blood thinners may need to be adjusted.
• Diagnostic Tests: Blood tests, EKG, and imaging studies like Doppler ultrasound or angiography to assess the extent of the blockage.

Procedure Description

1. Step-by-Step:
   1. Patient lies on an operating table; local anesthesia is administered.
   2. A small puncture is made, usually in the groin area.
   3. A catheter is guided through the blood vessels to the site of the blockage using X-ray imaging.
   4. A drug-coated balloon is inflated to open the artery and deliver medication.
   5. The balloon is then deflated and removed, leaving the artery widened.
2. Tools and Equipment: Catheter, drug-coated balloon, imaging equipment.
3. Anesthesia: Mostly local anesthesia; sedation may be provided.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Usually performed in a hospital’s catheterization laboratory (cath lab) or outpatient surgical center.

Personnel

• Interventional cardiologist or vascular surgeon
• Nurses
• Radiologic technologists
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common Risks: Bleeding at the puncture site, bruising, or hematoma.
• Rare Risks: Blood vessel damage, allergic reaction to contrast dye, infection, or kidney damage.

Benefits

• Expected Benefits: Improved blood flow, reduced pain and symptoms of PAD, quicker wound healing.
• Timeline: Benefits are often noticed within days to weeks post-procedure.

Recovery

• Post-Procedure Care: Patients are usually monitored for several hours; bed rest is often recommended.
• Recovery Time: Most patients can resume normal activities in a few days but should avoid strenuous activities for a week.
• Follow-Up: Scheduled follow-up appointments to monitor vessel health and medication effectiveness.

Alternatives

• Other Treatments: Lifestyle changes (diet, exercise), medication management, traditional balloon angioplasty, stent placement, or surgical bypass.
• Pros and Cons: Drug-coated balloon angioplasty has the advantage of delivering medication directly to the site but may not be suitable for all patients.

Patient Experience

• During Procedure: Mild discomfort at the puncture site, some pressure as the balloon is inflated.
• After Procedure: Some bruising and soreness; pain management through prescribed medication. Most discomfort subsides within a few days.