Angioplasty

Angioplasty is a minimally invasive interventional radiology procedure in which imaging technologies are used to guide a catheter into an artery or vein to the point where it is narrow or blocked. The vessel is then enlarged with a balloon-tipped catheter. Angioplasty is used as an alternative to surgery in order to enlarge an abnormally narrowed blood vessel. Examples include the narrowing of the arteries to the kidneys, which may cause high blood pressure, and the constriction of central veins due to use of central venous catheters.

How should I prepare my child for the angioplasty?

Explain to your child in simple terms why the test is needed and what will happen. We will give you specific instructions when the procedure is scheduled. In general:

• Your child must not eat any solid food for eight hours before the angioplasty.
• Your child may drink clear liquids up until three hours before the procedure.
• We may ask your child to take additional medication or to not take his or her usual medications the day before.

What will happen before the angioplasty?

A staff person from the hospital will call you a few days before the procedure. When you arrive:

• The interventional radiologist will talk to you about the procedure and ask you to sign the consent form. (You must be your child’s legal guardian to sign this form. If you are a legal guardian and not a parent, you must bring the paperwork showing proof of legal guardianship.)
• Your child will change into a hospital gown.
• A nurse or anesthesiologist may start an intravenous (IV) line.

Once your child is asleep, you will be escorted to a special waiting area.

What happens during the angioplasty?

The radiology technologist will clean your child’s groin with a special liquid that helps prevent infection. The interventional radiologist will give some numbing medication through a tiny needle into the cleaned area.

Guided by x-ray images, the radiologist will insert a long, thin tube (the catheter) into the appropriate blood vessel, usually at the crease of the hip. The radiologist will inject a special contrast solution through the catheter so that he can see your child’s blood vessels more clearly.

Once the radiologist has identified and measured the narrowed blood vessel, the radiologist will exchange the initial catheter for one with an inflatable balloon around its shaft. Guided by x-ray images, the radiologist will inflate the balloon and, if necessary, take blood pressure measurements to ensure that the vessel has been adequately widened.

When the procedure is finished, the radiologist removes the catheters and applies a bandage.

What happens after the procedure?

Your child is transferred to the recovery room, where you may join him. A nurse will watch your child closely for four to six hours, and your child will need to lie still without bending the leg during that time.

The interventional radiologist will speak with you after the procedure and explain the findings and results.

Is it safe?

Balloon angioplasty is a widely used technique that has been proven safe and effective for treating constricted blood vessels. The doctor will explain potential side effects and complications before you are asked to consent to the procedure.

Your child will be exposed to ionizing radiation (x-rays) during the procedure. We believe that the benefit to your child’s health outweighs the exposure that occurs during the angioplasty. Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.

How Boston Children’s Hospital approaches angioplasty

Angioplasty in children is different than in adults, because children have smaller and more delicate blood vessels. Our interventional radiologists, the doctors who perform the procedure, are highly trained in using the specialized techniques and small catheters necessary for angioplasty in children.

In addition to the interventional radiologist, your child will be treated by a team of anesthesiologists, nurse practitioners, nurses, and technologists who specialize in caring for children who have undergone interventional radiology procedures and treatments.

We perform angioplasties in our suite on the second floor of the hospital, which features three procedure rooms equipped with the latest imaging technology, a recovery area for patients who have received sedation or anesthesia, and examining rooms for outpatient visits.