Friday, October 29, 2010

Angioplasty



Angioplasty is the most common and also the latest procedure to treat Atherosclerosis.
Atherosclerosis is a condition where a fatty substance called plaque (plak) can build up in your arteries, causing them to harden and narrow.  Atherosclerosis can affect any artery in the body. When atherosclerosis affects the coronary arteries, the condition is called coronary heart disease (CHD) or coronary artery disease.
When the patient is diagnosed with CHD, then doctors recommend Coronary angioplasty, which is a procedure used to open blocked or narrowed coronary (heart) arteries. The procedure improves blood flow to the heart muscle.
The procedure is used to:
·      Improve symptoms of CHD, such as angina and shortness of breath. (Angina is chest pain or discomfort.)
·      Reduce damage to the heart muscle caused by a heart attack. A heart attack occurs if blood flow through a coronary artery is completely blocked. The blockage usually is due to a blood clot that forms on the surface of plaque.
·      Reduce the risk of death in some patients.
The full medical name for the angioplasty is percutaneous transluminal coronary angioplasty.
During the procedure, an angioplasty balloon, which is a medical device, is inserted into a clogged artery and inflated within the artery to clear blockage and allow blood flow. Before angioplasty, bypass surgery was the only option for people with clogged arteries. In bypass surgery, doctors used to open the patient's chest to reroute blood vessels to the heart. Angioplasty is less invasive, as the balloon is inserted through blood vessels and the chest remains closed. Patient recovery time is also faster with angioplasty, than with bypass surgery.
Angioplasty is performed under local anesthesia, so the doctor can ask if the patient feels any pain during the procedure. The surgeon opens the femoral artery at the top of the leg, and passes a catheter threaded on a thin guide wire into the blood vessel. The catheter, which is a tubular medical device, is about 3 ft (91 cm) long. The surgeon feeds the catheter through the blood vessels into the coronary artery. The catheter releases dye, so its precise position can be seen on a fluoroscope, which is an instrument used for observing the internal structure by means of X -ray. When the first catheter is in place at the clogged artery, the surgeon feeds a smaller, balloon-tipped catheter through it, then inflates the balloon for a few seconds. It reaches a diameter of about an eighth of an inch (0.3 cm). If the patient does not feel any pain, then the doctor proceeds to inflate the balloon for a full minute. This clears the arterial blockage, and then the catheters are removed. The patient is treated with prescription drugs to thin the blood and prevent clots, and should recover from the operation within weeks.
What Types of Interventional Procedures Are Used in Angioplasty?
There are several types of interventional procedures that doctor use when performing angioplasty. These include:
·      Balloon Angioplasty: A specially designed catheter with a small balloon tip is guided to the point of narrowing in the artery.
·      Stent: A stent is a small metal mesh tube that acts as a scaffold to provide support inside your coronary artery. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed coronary artery.
·      Rotoblation: A special catheter, with an acorn-shaped, diamond-coated tip, is guided to your coronary artery where it spins around at a high speed and grinds away the plaque on your artery walls.
·      Atherectomy: The catheter used in this procedure has a hollow cylinder on the tip with an open window on one side and a balloon on the other. When the catheter is inserted into the narrowed artery, the balloon is inflated, pushing the window against the fatty matter.
·      Cutting Balloon: The cutting balloon catheter has a special balloon tip with small blades. When the balloon is inflated, the blades are activated. The small blades score the plaque and then the balloon compresses the fatty matter into the artery wall.

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