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Endoluminal Angioplasty in Nice

Dr. Ilya Khantalin, Vascular Surgeon in the Alpes-Maritimes

Endoluminal Angioplasty

Dr. Ilya Khantalin in Nice

Today, endovascular techniques are the most modern and most commonly used methods by vascular surgeons for the treatment of arterial diseases. These procedures are validated and monitored by the French National Health Authority (HAS) and are part of the standardized protocols of endovascular surgical techniques and best practices.

These techniques require sophisticated tools and regulated, specialized devices using ionizing radiation. These highly technical endovascular procedures allow for correction of blood flow in arteries affected by the most common vascular pathologies.

Endoluminal angioplasty is an essential endovascular technique that uses a plain or drug-coated balloon to treat narrowed or blocked arteries. In Saint-Laurent-du-Var, Dr. Ilya Khantalin, vascular surgeon, offers his expertise to assess and treat arterial diseases, particularly those requiring this angioplasty technique.

Vascular diseases are recognized as Long-Term Conditions (ALD), making them eligible for 100% coverage by the French Social Security.

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What is balloon endoluminal angioplasty?

Vascular Surgeon in Saint-Laurent-du-Var

Simple angioplasty with a plain or drug-coated balloon is a minimally invasive endoluminal procedure aimed at restoring adequate blood flow in a blocked artery, particularly in the abdominal aorta and iliac arteries, lower limb arteries, carotid arteries, brain-supplying arteries, subclavian arteries, vertebral arteries, supra-aortic trunks, visceral arteries, renal arteries, etc.

Drug-coated balloon angioplasty uses a balloon coated with an antiproliferative drug (e.g., paclitaxel), which inflates at the stenosis site to dilate the artery. The drug released by the balloon helps prevent restenosis by reducing cellular proliferation.

This approach offers lasting improvement in blood flow by limiting scar tissue formation that could narrow the artery again.

Indications and Treatment with Endoluminal Angioplasty

Vascular Surgery Specialist in Saint-Laurent-du-Var

Endoluminal angioplasty using a plain or drug-coated balloon is mainly indicated for patients with peripheral arterial disease. It is particularly recommended in the following cases:

  • Supra-aortic trunk arterial disease: For stenosis (narrowing) or occlusion of the supra-aortic trunks and brain-supplying arteries such as carotids, subclavians, vertebral arteries. This technique helps restore adequate blood circulation and prevents complications such as stroke (CVA) or transient ischemic attack (TIA).
  • Peripheral artery disease (PAD), e.g., lower limb arteriopathy: In cases of narrowing or occlusion of the lower limb arteries—at the aorto-iliac level or in the femoral, popliteal, or tibial arteries—this technique restores proper blood flow and helps prevent chronic pain, ulcers, or even lower limb amputation in severe cases.
  • In-stent restenosis: This technique is also suitable for cases where an artery previously treated with a stent becomes narrowed again. Balloon angioplasty (plain or drug-coated) can help avoid repeat stenting or open surgery like bypass.

Angioplasty procedures are performed in modern, spacious hybrid operating rooms equipped with advanced equipment including ionizing radiation imaging systems, ultrasound, Doppler ultrasound, patient monitoring systems, and all types of anesthesia equipment.

  • Preparation: A consultation with the vascular surgeon is required to assess the appropriateness of endovascular treatment. Imaging tests such as Doppler ultrasound or CT angiography help precisely locate the lesions.
  • Anesthesia Consultation: The angioplasty may be performed under local, regional, or general anesthesia.
  • Arterial Access: A specialized needle is used to puncture the artery, followed by the introduction of a micro-catheter and a guidewire, which then allows placement of a sheath (introducer).
  • Angiography: Using ionizing radiation and contrast dye, the arterial tree is visualized, and lesions are diagnosed in real time.
  • Balloon Introduction: Balloons come in different sizes based on the artery’s diameter and lesion length. The surgeon introduces a catheter with a balloon over the guidewire, usually via the groin or elbow.
  • Dilation and Drug Release: Once positioned at the stenosis, the balloon is inflated to dilate the artery and release the antiproliferative drug to prevent scar tissue formation.
  • Withdrawal and Verification: After a few minutes, the balloon is deflated and removed. A final angiogram is performed to check that the blockage has been resolved, confirm procedural success, and ensure improved blood flow.

The entire procedure usually takes between 30 minutes and 1.5 hours. It is followed by a monitoring period of 6 to 24 hours before the patient can return home. This procedure may be done on an outpatient basis.

Post-operative monitoring is crucial to the success of plain or drug-coated balloon angioplasty. It includes:

  • Clinical Surveillance: Follow-up appointments are scheduled to check for complications and assess artery function.
  • Imaging Follow-Up: Doppler ultrasound or new angiography may be done in the months following to assess artery patency and detect any recurrence.
  • Medication: Antiplatelet therapy is generally prescribed to reduce the risk of clot formation.
  • Lifestyle Modifications: Smoking cessation, a healthy diet, and regular physical activity are recommended to optimize long-term outcomes.

An annual check-up with the vascular surgeon is advised, particularly for patients with risk factors such as diabetes, high blood pressure, or high cholesterol.

Like any medical procedure, plain or drug-coated balloon angioplasty has both benefits and risks. Its main advantages include reduced risk of recurrence, no foreign object left in the artery (unlike stents), and rapid symptom relief.

Risks are significantly lower compared to open surgery. However, rare risks may include:

  • Hematomas or bleeding at the puncture site
  • Local infections
  • Medium-term restenosis, sometimes requiring retreatment

This procedure is an effective solution to restore arterial blood flow without placing a stent, thereby reducing long-term complication risks.

For any questions or to schedule an appointment, contact Dr. Ilya Khantalin in Saint-Laurent-du-Var. A complete assessment will determine whether endoluminal angioplasty with a plain or drug-coated balloon is suitable for your case.

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