The Vascular Surgery team at the University of Michigan is dedicated to providing exceptional patient care in the U-M Cardiovascular Center (CVC), our new state-of-the-art clinical building.

Our surgeons have extensive experience performing cryoplasty for the treatment of peripheral vascular occlusive disease and are continuing to investigate and research new advances for treatment in this area.

What is cryoplasty?

Cryoplasty or cryo-balloon angioplasty is a procedure very similar to angioplasty in which your vascular surgeon inserts a balloon catheter into a blocked artery to repair an obstruction within the vessel. In conventional angioplasty, depending on the location of the blockage, a stent may be inserted at the location of the repair to prevent the blockage from returning, a condition referred to as restenosis.

In cryoplasty, once the balloon catheter reaches the site of the blockage, it is filled with liquid nitrous oxide, which immediately evaporates into a gas, causing the balloon to inflate and freeze the surrounding tissue. This cooling to 14 deg F (-10 deg C) promotes the dilation or opening of the artery, minimizes the potential for growth of new scar tissue, and reduces the likelihood that the blockage in the treated location will reoccur. Generally a stent is not used in this procedure, as the freezing at the site of the repair is less likely to cause restenosis or the re-narrowing or blockage of the vessel.

Conditions	Treatments
Cryoplasty (also known as: cryo-balloon angioplasty)	Atherosclerotic blockages of the peripheral vasculature

Who is a good candidate for cryoplasty?

You are a good candidate for an angioplasty if you have severe narrowing of any of your peripheral arteries and the blockage is producing a problem. For example, a blockage can occur in your leg arteries producing pain in your legs when you walk, it could be in the arteries that supply your brain making you at risk for stroke, or they could be in your kidney arteries causing severe hypertension.

U-M vascular surgeons who perform cryoplasty

For details about education, experience, and specialty in this clinical area, please visits these physician profile pages:

How do I prepare for cryoplasty?

Your doctor will give you detailed instructions as to how to prepare for the procedure. These may include a suggestion to eat a light meal the night before the procedure and to not eat or drink anything after midnight before the procedure. If you regularly take any important medicines, your physician may ask you to take them on the day of surgery with a sip of water.

Follow your doctor's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your body will heal much better if you do not smoke after the surgery.

Other Considerations

Plan for your care and transportation after the procedure and during recovery at home.
Before the procedure tell your health care provider if you have had any kidney problems or reactions to iodine-containing foods or chemicals, such as seafood or kidney contrast dye.
Before surgery, your health care provider will ask you to sign a consent form for angioplasty, bypass surgery, and angiography. Angiography is an x-ray study of the blood vessels using dye. This consent form is needed in case problems arise during the angioplasty and emergency surgery is needed.
You will have blood tests, and an electrocardiogram (ECG) before the procedure.
Someone at the hospital will shave and wash the area where the catheter will be inserted (arm or groin) to help prevent infection.

What happens during the procedure?

You will be given a local anesthetic to numb the area where the catheter will be inserted. You will stay awake during the procedure.

Your vascular surgeon will thread a thin wire into the blocked artery through a needle inserted into a blood vessel in your groin. Dye is injected into the artery and X-rays are taken while the dye moves through your artery. Using these X-ray images, a balloon catheter will be placed across the blockage via a guide wire. A catheter is a thin tube inserted into a blood vessel in your groin. Once the balloon is positioned across the blockage, it is inflated with liquid nitrous oxide. The location of the blockage freezes, and the blocked portion of the vessel opens improving blood flow. You may feel mild discomfort while the balloon is inflated. The balloon and catheter are then removed.

What happens after the procedure?

You will go back to your hospital room and rest in bed for 12 to 24 hours. You will most likely be able to go home the next day. You can usually resume normal activity within a day or two. You may be temporarily placed on a medication called Plavix.

People with successful cryoplasty have good long-term results. Some people's arteries may narrow again which may require a repeat of the procedure. This usually happens within 3 to 6 months of having the procedure.

What are the risks?

You may have an allergic reaction to the local anesthetic or x-ray dye.
You may bleed a lot and need medicine or a blood transfusion.
The artery may be damaged. For example, the artery might be perforated during the procedure. Emergency bypass surgery or repair of the perforation (hole) would then be needed.
There is a risk of injury to the groin where the catheter was inserted.
The blockage may come back after 3 to 6 months.
Although rare, a procedure involving the brain arteries could cause a stroke.

There is risk with every treatment or procedure. Talk to your surgeon for complete information about how the risks apply to you.

How can I take care of myself following surgery?

Do not smoke.
Eat a healthy diet that is low in fat and cholesterol.
Exercise according to your health care provider's recommendation.
Keep your appointment for your scheduled post-discharge office visit.

When should I call my health care provider?

Call your health care provider right away if:

You have chest pain.
You have constant or worsening pain or numbness in your arm or leg.
You have a fever.
You have shortness of breath.
Your leg becomes blue and cold.
You have bleeding, excess bruising, or a lot of swelling where the catheter was inserted.

Make an appointment or contact us for more information.