Angioplasty can be used to open narrowed arteries in the legs, just as it does in the heart. Like angiography, it involves inserting a thin tube (catheter) into the femoral artery at a point near the groin, then threading it down into the thigh.
However, instead of releasing a dye, this catheter carries a balloon on its tip. By inflating this balloon at the site of the blockage, the doctor can push the plaque back against the artery walls. Typically, a small length of expandable metal mesh tubing (called a "stent") is then placed at the site to keep the artery open. Experimental biodegradable stents – which are fully absorbed by the body within two years of implantation – have been successfully tested in a group of Japanese patients. These new stents may be less likely to trigger the inflammatory reactions and injuries occasionally caused by metal stents.
Balloon angioplasty works best on short, thick blockages in major arteries. It won't work on scattered blockages in thin, small arteries.
For the right people, it's usually safe and effective, but there is a significant chance that the blockages will form again. The procedure is less risky and expensive than surgery, and requires a much shorter hospital stay.
If artery-clearing procedures are recommended for your leg pain, it's wise to seek a second opinion: up to 90% of people with intermittent claudication will find that their symptoms stabilize or improve with nothing more than the passage of time and simple lifestyle changes. That means only one in 10 will need "intervention" in the form of angioplasty or surgery. The most likely candidates are folks who face serious tissue damage or risk of amputation from impaired blood flow and those whose pain is so severe that it interferes with the activities of daily living.
Aside from angioplasty, another non-surgical approach coming into wider use is atherectomy. In this procedure, the doctor uses a catheter tipped with a rotating cutter to ream out the blockage. Also in use are catheters tipped with lasers that burn off the plaque.