Minimally Invasive Procedures for Aortoiliac Occlusive Disease

When lifestyle changes and medication don’t relieve symptoms of aortoiliac occlusive disease, NYU Langone vascular specialists may perform minimally invasive procedures to improve blood flow to the lower body. 

These techniques provide alternatives to those who are not good candidates for surgery because of medical conditions that make surgery dangerous. 

Your doctor may perform one or more of these procedures to widen the iliac artery.

Atherectomy

If you have a severe artery blockage, your doctor may recommend an atherectomy, a procedure in which the doctor removes plaque—a waxy substance composed of fat, cholesterol, and calcium—by shaving, cutting, or vaporizing it.

During an atherectomy, the surgeon inserts a catheter—a thin, hollow tube—above the femoral artery in the groin. He or she guides the catheter to the blocked area of the artery and removes plaque using a tool attached to the tip. 

The surgeon may then perform a balloon angioplasty and stenting, which helps to prevent future blockages.

An atherectomy is performed either in the doctor’s office or in the hospital using a local anesthetic and a mild sedative. Most people can go home the day of the procedure.

Balloon Angioplasty and Stenting

Balloon angioplasty and stenting often accompanies an atherectomy. During the procedure, the surgeon makes a puncture with a needle in the groin and advances a long catheter through the femoral artery to the blockage in the iliac artery. A tiny balloon at the end of the catheter is inflated, pushing plaque to the sides of the artery’s walls, making room for blood to flow. 

Next, the doctor inserts a metal mesh tube called a stent into the artery through the catheter and opens it. This stent prevents the iliac artery from narrowing again.

When the procedure is done, the surgeon removes the balloon and catheter but leaves the stent in place permanently. 

The procedure, which is performed using local anesthesia, lasts 30 to 90 minutes, depending on the severity of the blockage. It can be done in the doctor’s office or in the hospital with or without an overnight stay, depending on your overall health. Most likely, you can resume your usual activities within two days.

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