Angioplasty is the technique of mechanically widening a narrowed or obstructed
blood vessel; typically as a result of
atherosclerosis. Tightly folded balloons are passed into the narrowed locations and then inflated to a fixed size using water pressures some 75 to 500 times normal blood pressure (6 to 20 atmospheres).
The word is composed of the medical combining forms of the
Greek words αγγειος
aggeîos meaning "vessel" and πλαστός
plastós meaning "formed" or "moulded". Angioplasty has come to include all manner of
vascular interventions typically performed in a minimally invasive or
percutaneous method.
A
coronary angiogram (an X-ray with radio-opaque contrast in the coronary arteries) that shows the left
coronary circulation. The distal
left main coronary artery (LMCA) is in the left upper quadrant of the image. Its main branches (also visible) are the
left circumflex artery (LCX), which courses top-to-bottom initially and then toward the centre-bottom, and the
left anterior descending (LAD) artery, which courses from left-to-right on the image and then courses down the middle of the image to project underneath the distal LCX. The LAD, as is usual, has two large diagonal branches, which arise at the centre-top of the image and course toward the centre-right of the image.
Coronary angioplasty
Main article: Percutaneous coronary interventionPercutaneous coronary intervention (
PCI), commonly known as
coronary angioplasty is a therapeutic procedure to treat the
stenotic (narrowed)
coronary arteries of the
heart found in
coronary heart disease. These stenotic segments are due to the build up of
cholesterol-laden plaques that form due to
atherosclerosis. PCI is usually performed by an
interventional cardiologist.
Peripheral angioplasty
Peripheral angioplasty refers to the use of mechanical widening in opening blood vessels other than the coronary arteries. It is often called
percutaneous transluminal angioplasty or
PTA for short. PTA is most commonly done to treat narrowings in the leg arteries, especially the common iliac, external iliac, superficial femoral and popliteal arteries. PTA can also be done to treat narrowings in veins, etc.
Renal artery angioplasty
Atherosclerotic obstruction of the
renal artery can be treated with angioplasty of the renal artery (percutaneous transluminal renal angioplasty, PTRA).
Renal artery stenosis can lead to
hypertension and loss of
renal function.
Carotid angioplasty
Generally,
carotid artery stenosis is treated with angioplasty and
stenting for high-risk patients in many hospitals. It has changed since the FDA has approved the first carotid stent system (Cordis) in July 2004 and the second (Guidant) in August 2004. The system comprises a stent along with an embolic capture device designed to reduce or trap
emboli and clot debris. Angioplasty and stenting is increasingly being used to also treat carotid stenosis, with success rates similar to
carotid endarterectomy surgery. Simple angioplasty without stenting is falling out of favor in this vascular bed. SAPPHIRE, a large trial comparing carotid endarterectomy and carotid stenting with the Cordis stent found stenting non-inferior to carotid endarterectomy
. See also
References
- ^ Yadav JS, Wholey MH, Kuntz RE, et al (October 2004). "Protected carotid-artery stenting versus endarterectomy in high-risk patients". N. Engl. J. Med. 351 (15): 1493–501. doi:10.1056/NEJMoa040127. PMID 15470212.
source from:wikipedia.org