ANGIOPLASTY

ANGIOPLASTY
• is the mechanical widening of a narrowed or totally obstructed blood vessel. These obstructions are often caused by atherosclerosis.

DIFFERENT KINDS OF ANGIOPLASTY

Coronary Angioplasty /Percutaneous Coronary Intervention (PCI) • is a therapeutic procedure to treat the stenotic 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

Peripheral Angioplasty/Percutaneous • most commonly done to treat Transluminal Angioplasty (PTA) 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

Renal Artery Angioplasty/Percutaneous Transluminal Renal Angioplasty(PTRA)

• Atherosclerotic obstruction of the renal artery can be treated with angioplasty. • Renal artery stenosis can lead to hypertension and loss of renal function.

Procedure:
• Once the anesthetic has numbed the area, a small incision will be made in the skin. When doctors see the artery into which the catheter will go, a special needle is used to penetrate it. Doctors usually put the catheter into an artery in your leg, arm, or wrist. Most doctors use the artery in the leg.

Doctors gently thread the catheter through the artery and into your heart. They use a video monitor (like a TV screen) to see the process. Once the catheter reaches the blocked artery, a harmless dye is injected, and the doctor will take a picture of the coronary arteries (called a coronary angiogram). The angiogram helps the doctor see the size and location of the blockage.

• Once doctors know the exact location of the blockage, they thread what is called a guidewire through the same artery in the leg and advance it across the blockage.

• Then, the balloon-tipped catheter is slipped over the guidewire and advanced to the blockage. When this catheter reaches the blockage, the balloon is inflated. As the balloon expands, the stent presses against the plaque, compressing it against the artery wall. When the stent is already in place the doctor will deflate the balloon catheter to withdraw the guidewire and leave the stent in

STENT
• a wire metal mesh tube used to prop open an artery during angioplasty • When the balloon is inflated, the stent expands, locks in place and forms a scaffold. This holds the artery open

• Within a few weeks of the time the stent was placed, the inside lining of the artery (the endothelium) grows over the metal surface of the stent. • Reclosure (restenosis) is also a problem with the stent procedure

KINDS OF STENT
• Drug Eluting Stents - These are coated with drugs that are slowly released and help keep the blood vessel from reclosing

Stent Graft
• A stent graft is a tubular device, which is composed of special fabric supported by a rigid structure, usually metal. • These stents are used mainly for vascular intervention. • Stent grafts are used to support weak points in arteries, commonly known as an aneurysm.

Nursing Consideration
• Monitor heart rate and BP • Keep the area where the catheter was inserted dry for 24 to 48 hours. • Advice pt. to perform ambulation within 6 hrs after the procedure • Make sure that the pt. takes an anti-coagulant drug as ordered by AP

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