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Arterial Revascularization for Peripheral Artery Disease

Doctor and male senior patient discussing revascularization

We’ve all done it; Googled our symptoms online and attempted to self-diagnose ourselves before ever setting foot into a doctor’s office. For most people, this can become quite confusing especially when difficult medical terms like revascularization come up in our search.

Before jumping to any conclusions, Dr. Yan Katsnelson explains what arterial revascularization is and how it can prevent serious health conditions like heart attack, stroke, and amputation from occurring.

What Does Revascularization Mean?

Image of angiogram depicting artery

Revascularization refers to the ability to restore blood flow to the heart or another part of the body, such as the lower extremities, once your arteries have become either partially or fully clogged with plaque. Arterial revascularization is typically recommended when an organ or body part has suffered from ischemia, which means inadequate blood supply. H2: What Is Ischemia? There are different terms for body parts or organs that are not receiving the right amount of circulation; these include:

  • Brain: Cerebral ischemia
  • Heart: Cardiac ischemia, ischemic heart disease, and myocardial ischemia
  • Intestines: Acute mesenteric ischemia or bowel ischemia
  • Extremities: Lower limb ischemia, also known as peripheral artery disease (PAD)

The type of ischemia you have depends on where it is located and its severity. Although it’s important to note that if you have ischemia, you are at an increased risk of arterial blockages anywhere in your body. Similarly, if you have a family or personal history of vascular disease, you’ll want to be regularly tested for all types of ischemia.

How Is Lower Limb Ischemia Diagnosed?

Doctor examining leg of woman in wheelchair

A revascularization procedure is typically recommended when one of your body parts or organs have not been getting enough blood flow with oxygen and nutrients. This can occur for a myriad of reasons such as blood vessel issues and arterial plaque buildup.

Lower limb ischemia located in the extremities such as the legs, ankles, or feet, is typically diagnosed by using a common test known as an ankle-brachial index (ABI). ABI tests can test the blood pressure in one leg compared to the other which will determine the severity of plaque buildup within the arteries, also known as peripheral artery disease (PAD).

Lower limb ischemia, which can disproportionately affect people with type 2 diabetes or a family history of vascular disease, is almost always caused by PAD. Your vascular specialist will need to determine the severity of your PAD to be able to suggest the right lower limb revascularization procedure.

Types of Revascularization Procedures

Computer generated image of stent angioplasty

There are many types of revascularization procedures for different kinds of blockages. If the blockage is located in the peripheries causing lower limb ischemia, then the revascularization procedures would include:

Endovascular revascularization procedures (treating the blocked artery within the blood vessel) like stent angioplasty or atherectomy, are both considered non-surgical treatments. In contrast, peripheral artery bypass, where a graft is used to replace or bypass the blocked artery, is a surgical revascularization procedure.

If you’re looking to avoid a long, expensive hospital stay, endovascular revascularization procedures can be performed in an outpatient setting without general anesthesia. This is because both stent angioplasty and atherectomy are nonsurgical treatments for lower limb ischemia and PAD. Unlike surgery, minimally invasive revascularization procedures utilize live guidance tools that allow patients to avoid major incisions, long recoveries and post-op stitches.

Why Would You Need Revascularization for PAD?

Person with leg pain holding leg as they sit on bed

Depending on the severity, many people with lower limb ischemia and peripheral artery disease experience painful symptoms in their thighs, buttocks, calves, ankles, or feet due to blocked arteries. Additionally, they may experience limited mobility that decreases their quality of life. This is caused by plaque buildup (cholesterol in the blood that sticks to the walls of your arteries) that either partially or fully blocks blood flow from reaching the lower extremities. These symptoms of lower limb ischemia can be detrimental to your health potentially leading to heart attacks, strokes, or even amputation.

Nonsurgical arterial revascularization procedures such as stent angioplasty and atherectomy can open up narrowed arteries and allow blood to flow freely to the extremities. Once this occurs, patients usually start seeing improvements in their leg pain and mobility. The severity of your lower limb ischemia will determine if you are a good candidate for these arterial revascularization procedures or if you need to undergo amputation. Peripheral artery disease and lower limb ischemia can easily be treated if diagnosed early; that’s why it’s important to consult a vascular specialist as soon as possible.

How Do Doctors Perform Lower-Extremity Revascularization?

Doctor holding catheter up

Lower-extremity revascularizations can be performed a few different ways; however, Yan Katsnelson, M.D. will focus on two specific treatments: stent angioplasty and atherectomy. Many people who are facing lower limb ischemia and peripheral artery disease may be interested in avoiding surgical procedures. Thankfully, both stent angioplasty and atherectomy are performed non-surgically with very few risks and quick recovery period compared to surgery.

Stent Angioplasty

Angioplasty is typically used when your blood flow to your lower extremities is completely or almost completely blocked. Your vascular specialist will determine your severity and if you are a good candidate for stent angioplasty. This nonsurgical lower-extremity revascularization treatment involves making a tiny incision where an even smaller catheter will be threaded through the affected artery.

If you’re worried about going under general anesthesia for lower limb revascularization, you can breathe easy. Instead, stent angioplasty is performed using a combination of a light sedative and local anesthesia. The specialist will use live-guided technology to navigate the catheter to the location of the blockage. Then, a mesh stent that is expanded by a tiny balloon will be placed within the artery. As the stent expands, it compresses the formation of plaque buildup towards the walls of the arteries so that the blood can flow freely. Once the stent is placed and a passageway for blood has been made, the catheter will be taken out. The specialist will place a bandage over the incision site and you will be able to rest for a bit until you are ready to go home.

With outpatient revascularization procedures like stent angioplasty, you’ll be able to go home right away to recover in the comfort of your home. Lower-extremity revascularizations like stent angioplasty typically take between 30 to 45 minutes from start to finish, which makes it one of the quickest, effective treatments for lower limb ischemia and PAD.


In comparison, atherectomies are slightly more outdated than angioplasty treatment; however, it is still a nonsurgical revascularization option that gives patients relief from the painful symptoms associated with lower limb ischemia and PAD. An atherectomy revascularization procedure is also performed under live-guidance technology to remove plaque from a blocked artery. During an atherectomy, the plaque is shaved or vaporized away with tiny rotating blades or a laser on the end of a tiny catheter.

Like angioplasty, there is no need for general anesthesia for lower limb revascularization. Your vascular specialist will use a combination of a light sedative and local anesthesia (similar to the dentists’ office) to make sure the patient is comfortable at all times. This lower-extremity revascularization procedure takes about two hours from start to finish, allowing the patient to return to recover at their home.

Preventing Amputation Caused by PAD with Revascularization Procedures

Man sitting on bed with fake leg next to him

Gangrene leading to amputation is a reality for many people with PAD. In fact, 54% of the estimated 1.6 million Americans with amputated limbs lost their legs or feet due to vascular conditions including peripheral artery disease, lower limb ischemia, and diabetes. Thankfully, arterial revascularization procedures can help people with blood vessel blockages avoid life-threatening health issues like heart attack, stroke, and amputation.

Gangrene can occur when circulation has been severely cut off from the lower extremities resulting in tissue death. This an extreme form of lower limb ischemia and PAD that has been ignored and left untreated. Unfortunately, many people aren’t aware of how common these two vascular conditions are. Luckily, there are revascularization procedures that are out there that can help you restore blood flow and avoid gangrene as well as amputation.

Arterial Revascularization with Stent Angioplasty

Doctor speaking with senior patient about treatment options

At USA Vascular Centers, our vascular specialists perform lower-extremity revascularization treatments so people with lower limb ischemia and peripheral artery disease can live a healthier life. We believe that people should have convenient access to an outpatient vascular center in their hometown; that’s why we have expanded our state-of-the-art centers across the nation.

If you’re ready to take the next step and treat your lower limb ischemia and PAD before it’s too late, you can count on us. Our specialists will combine lifestyle changes with arterial revascularization like stent angioplasty to develop a treatment plan that’s right for you. Give us a call at 888.773.2193 or schedule conveniently online.

Booking arterial revascularization for lower limb ischemia and peripheral artery disease has never been easier. What are you waiting for? Learn more and get on to a healthier, more active life today.


Dr. Yan Katsnelson is a philanthropist, business owner, and highly skilled cardiac surgeon. He is the Founder and CEO of USA Vascular Centers, which is part of USA Clinics Group, the parent company of USA Fibroid Centers, USA Vein Clinics, and USA Oncology Centers with more than 90 facilities nationwide. Dr. Yan has established himself as a strong advocate for accessibility and affordability of the most advanced medical care close to home, and his mission is to create a positive experience for each patient with compassionate, personalized, and expert care.

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