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| SURGERIES OF THE HEART |
Atherectomy/Angioplasty of Noncoronary Vessel
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Atherectomy and Angioplasty are methods that can be used to open the arteries without surgery.
There are several different devices that can be threaded through blood vessels to the site of a narrowing or occlusion. Once there, these devices remove the obstruction so that blood flow is restored.
* Shavers chew away and remove tiny pieces of the obstruction until blood flow is restored.
* Burrs grind the obstruction into tiny particles that are so small they are washed away in the blood.
* Lasers vaporize the obstructing material.
* Balloons inflate within the obstruction, pushing the material aside.
* Stents are metal tubes that expand once in place, forming a rigid framework to hold the artery open.
REASONS FOR THE PROCEDURE
Most often these procedures are done when an artery is so narrowed by atherosclerosis that enough blood is no longer able to pass through. The body part then suffers from Ischemia (lack of oxygen). Legs cramp, the brain suffers from or threatens to have a stroke , and the bowel can produce bloody diarrhea. If a kidney has inadequate blood supply, it will raise blood pressure throughout the body. Occasionally, the vascular access needed to perform hemodialysis for kidney failure narrows and requires this procedure to reopen it.
RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE
Aside from the general health and the extent of disease in the arteries, the only significant risk factor is the status of the blood clotting system, which will be thoroughly evaluated before proceeding.
BEFORE THE PROCEDURE
The patient will be thoroughly evaluated before deciding upon the best procedure. This may involve contrast x-rays, ultrasound, or computerized scans (CTA or MRA) to identify the area or areas of concern. The patient will be asked not to have anything by mouth for several hours before the procedure.
PROCEDURE
The patient will be lying down in a special procedure room similar to a surgical suite. It will be filled with x-ray machines as well as an array of surgical equipment. Depending upon what artery is to be opened, a blood vessel in the groin or arm will be prepared and covered with sterile drapes. The doctor will then puncture the numbed skin and thread the long device into the blood vessel to the site of the obstruction. Dye may be injected through the device to visualize the obstruction and assure that the device is in the right place. There may be more than one location that requires opening.
AFTER THE PROCEDURE
Recovery time is minimal. The patient may have to probably spend the night in the hospital to make sure there are no complications, and a medication such as aspirin may be prescribed to the patient to prevent blood clots.
TIME TO BE TAKEN FOR THE PROCEDURE
30 minutes to two hours.
POSSIBLE COMPLICATIONS
* The principal risk is that the artery will close again after the procedure. If this happens, either a repeat procedure or a similar one will be required, or open surgery will have to be performed—usually urgently.
* Rarely, the artery may be damaged, requiring surgical repair.
* There may be bleeding from the puncture wound in the skin through which the device was introduced.
* If the carotid artery is the site of the procedure, a stroke may occur.
POSTOPERATVE CARE
There will be a bandage over the puncture site. The patient may be prescribed a “blood thinner” such as Aspirin. Certain strenuous activities will be limited. Other activities, including exercises and fluid intake, may be encouraged.
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| Last Modified :
Tuesday, May 12, 2009 |
Compiled and edited by the Editorial team and
approved by Expert panel of h4heart.com
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