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Cardiac catheterization offers diagnostic and therapeutic/interventional
treatment options for a variety of heart and vascular
problems. After administration of local anesthesia,
a catheter is inserted into the entry site (a blood
vessel in the leg, arm or neck) then guided via X-ray
technology to the area of interest.
Procedures offered include:
Atherectomy
Balloon angioplasty
Coronary angioplasty
Rotablation
Stents
Valvuloplasty
Vascular brachytherapy
Atherectomy
Catheter-based devices that actually remove the plaque
are referred to as atherectomy or ablation. A number
of types of ablation exist. One works like a shaver,
cutting the soft plaque from the obstruction site and
depositing it in a capsule, which is then removed through
the catheter. Another model cuts the plaque and suctions
it away. This generally adds 15 to 30 minutes to a procedure.
Balloon Angioplasty
This procedure also is known as angioplasty or balloon dilatation. The catheter used for this procedure has an inflatable elongated balloon on one end that is inflated to compress the plaque against the artery wall. The positioning of the balloon at the stenosis (an area of plaque buildup that causes narrowing of the artery), its inflation and the resulting increased flow following the procedure all are carefully viewed under X-ray by the cardiologist. Several inflations usually are made during the same procedure before the procedure is considered completed.
Coronary Angioplasty
Percutaneous transluminal coronary angioplasty (PTCA) refers to angioplasty in the coronary arteries to permit more blood flow into the heart. In this procedure, a catheter is used to compress plaque in the coronary artery, creating a bigger opening and allowing for blood to flow more freely.
Rotablation
Rotablation is a procedure performed on plaque in the arteries that has hardened and become calcified. A rotational atherectomy catheter --an olive-shaped diamond burr --rotates at a high speed and works like a sander to pulverize the plaque or obstruction into harmless microscopic particles that are washed away by the blood. This can add 15 to 30 minutes to the angioplasty procedure.
Stent
A stent is a tiny device that comes in a variety of sizes and designs to suit an individual patient's needs. A stent resembles a metal coil similar to a spring and is used in conjunction with a balloon catheter to open up the blocked artery and help keep it open. The stent is mounted on an angioplasty balloon and delivered through a catheter to the diseased area in the artery. The balloon is inflated, as is the stent along with it. Patients can sometimes feel "tightness" or "pressure" in the chest during the time that the balloon is inflated. When the balloon is deflated and withdrawn, the stent remains in place, serving as a permanent "scaffolding" for the newly unblocked artery. The natural lining of the artery grows over the surface of the stent within a few weeks. This usually adds 15 to 30 minutes to the angioplasty procedure. The patient stays in the hospital overnight once the procedure is completed.
Carotid Stent
The carotid arteries are the main blood vessels supplying blood flow to the brain. Before stent placement, a guide wire with a filter is positioned past the narrowed area in the carotid artery and a small balloon is inflated to widen the artery. Then a stent is placed to provide support. The filter captures particles that may have been released during the procedure, to prevent a stroke. Within weeks, the artery grows over the surface of the stent. The procedure normally can be completed in 60 minutes.
Coronary Stent
A coronary stent is used to treat coronary artery disease (CAD), which causes a narrowing of the coronary arteries, affecting blood flow to the heart. The stent is used to keep the coronary arteries expanded, forming a rigid support to increase blood flow. It often is used as a first line of treatment for CAD, reducing the need for bypass surgery.
Drug-Eluting Stent
The drug-eluting stent (DES) is a fairly new treatment option. These stents are coated with a special medication that is designed to slowly dissolve in the weeks after the stent is implanted, preventing the overgrowth of cells in the area of the artery that has been widened.
Peripheral Stent
A peripheral stent is used in the arteries in the legs, and sometimes arms, to increase blood flow throughout the peripheral areas of the body. Angioplasty is performed prior to implanting the stent.
Valvuloplasty
Valvuloplasty is a procedure in which a catheter with a large balloon is used to open a heart valve that has become narrowed, usually as a result of scarring. The catheter is inserted in the same manner as for a coronary angiogram procedure. The catheter is guided to the aortic or mitral valve. Once in place within the leaflets (flaps on the valve), the balloon is inflated until the leaflets are loosened. The balloon is then deflated and withdrawn from the body. This procedure usually takes 2 to 3 hours.
Vascular Brachytherapy
A new type of treatment, vascular brachytherapy, uses
certain forms of radiation to reduce the problem of
restenosis (renarrowing of the artery) after stent implantation.
This treatment is used to suppress the overgrowth of
tissue inside the previously stented area. Catheter-based
delivery systems that have radioactive tips are introduced
to the area of restenosis then withdrawn after a prescribed
length of time, which can be 15 to 30 minutes. The radiation
in the catheter destroys the cells that can otherwise
cause a renarrowing of the treated area.
If you would like to make an appointment or need assistance
to find an appropriate physician, please call us at
(888) LUHS-888.
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