Patient education: Peripheral angioplasty – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is peripheral artery disease? — Peripheral artery disease, or "PAD," is a condition that affects the blood vessels (called arteries) that bring blood to the limbs. The legs are more often affected than the arms.

Normally, blood flows easily through arteries to all parts of the body. But sometimes, fatty clumps called "plaque" build up inside the walls of arteries (figure 1). Plaque can cause arteries to become narrow or blocked. This prevents blood from flowing normally. Sometimes, small pieces of plaque can break off and cause a blockage.

Having good blood flow is important for health. When muscles do not get enough blood, it can cause symptoms like pain. When skin does not get enough blood, wounds might heal more slowly than normal.

What is angioplasty? — Angioplasty is a procedure to widen blood vessels that are too narrow or blocked. This can improve blood flow to the limbs.

During angioplasty, the doctor puts a thin tube, or "catheter," through the skin and into a blood vessel. They move the tube to the part of the blood vessel that is narrow or blocked. Then, they inflate a tiny balloon inside the artery to reopen it.

What is a stent? — A stent is a small mesh tube the doctor might use to hold a blood vessel open. A stent can be placed during angioplasty. The doctor decides whether or not to use a stent based on:

●Where the blockage is

●How much of the blood vessel is blocked

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

For the first 24 hours:

●Do not drive or operate heavy or dangerous machinery.

●Do not make any important decisions or sign any important papers.

●Do not drink alcohol of any kind.

You should also:

●Take care of the "access site" – This is the place where the tube was put into your blood vessel. It might be covered with a bandage or a clear dressing.

•Keep the access site covered for the first 1 to 2 days after surgery. Your doctor or nurse will tell you exactly how long to keep it dry.

•Once you no longer need to keep the access site dry, gently wash it with soap and water whenever you take a shower. Do not put the access site underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

•After you wash the access site, pat it dry. Your doctor or nurse will tell you if you need to cover it with a bandage or gauze.

•Always wash your hands before and after you touch your skin near the access site or bandage.

●Take your "antiplatelet" medicines as instructed, if you had a stent placed. This helps keep blood clots from forming and blocking the stent.

●Drink plenty of fluids for the next few days. This helps to clear the dye from your system.

●Increase your activity slowly:

•Start with short walks around your home as you are able, and walk a little more each day.

•Avoid heavy lifting for at least a week or 2. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)

●Eat when you are hungry – If you have an upset stomach, it might help to start with clear liquids and foods that are easy to digest, like soup, pudding, toast, or eggs. You can eat other types of foods when you feel ready. If your doctor or nurse gave you specific instructions about what to eat or avoid, follow them.

●Use a stool softener to help prevent constipation, if needed. This is a common problem if you take opioid pain medicines. Follow all instructions for taking your pain medicines.

What follow-up care do I need? — The doctor will want to see you again after the procedure to check on your progress. Go to these appointments.

If you have stitches, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or adhesive strips, these will fall off on their own. Do not pick at them or try to remove them yourself.

When should I call the doctor? — Call for emergency help right away if you think that you might be having a heart attack or stroke (in the US and Canada, call 9-1-1).

Symptoms of a heart attack can include:

●Severe chest pain, pressure, or discomfort with:

•Breathing trouble, sweating, upset stomach, or cold and clammy skin

•Pain in your arms, back, or jaw

•Worse pain with activity like walking up stairs

●Fast or irregular heartbeat

●Feeling dizzy, faint, or weak

Symptoms of a stroke can include:

●Sudden numbness or weakness of the face, arm, or leg, especially on 1 side of the body

●Sudden confusion, or trouble speaking or understanding

●Sudden trouble seeing in 1 or both eyes

●Sudden trouble walking, dizziness, or loss of balance or coordination

●Sudden severe headache with no known cause

You should also get help right away for other symptoms of blocked blood flow. If a piece of plaque breaks off and causes a blockage, symptoms can include:

●Sudden pain, paleness, and coolness, especially in the arm or leg that was treated

●Blotchy, discolored skin, especially in the arm or leg that was treated

●Worse symptoms in the arm or leg that was treated

●New symptoms in the other arm or leg

Call for advice if you have:

●A lot of bleeding where the tube went in

●Pain, numbness or tingling, or swelling where the tube went in or nearby

●A fever of 100.4°F (38°C) or higher, or chills

●Less urine than usual

More on this topic

Patient education: Angioplasty and stents for peripheral artery disease (The Basics)
Patient education: Peripheral artery disease and claudication (The Basics)
Patient education: Atherosclerosis (The Basics)

Patient education: Peripheral artery disease and claudication (Beyond the Basics)