An alternative to bypass surgery is balloon angioplasty. Angioplasty consists of accessing a blood vessel, usually the femoral artery in the lower extremity or the brachial artery in the upper extremity, with a device called a sheath. Through the sheath, various catheters may be inserted into the arteries under x-ray guidance.
Once the diseased area in the artery is identified, a small, flexible wire is used to cross the blocked or narrowed vessel followed by a catheter (with a balloon attached to the tip) that is tracked over the wire. The balloon is inflated within the diseased artery in an attempt to displace the plaque in the artery so that the blood will flow more easily across the vessel. Balloon angioplasty can also be performed in diseased veins and dialysis grafts/fistulas. The procedure is typically done as an outpatient, with the patient going home the same day.