Angioplasty
From Ganfyd
Any form of procedure designed to change the form of a blood vessel. It most commonly refers to widening of a stenosed blood vessel. The most common method is by inflation of an intra-luminal balloon, often followed by stenting.
There are multiple angioplasty technique variations including using percutaneous and open-access techniques, supplemented by radiological or direct visualization depending upon the vessel. See primary angioplasty if you are referring to coronary angioplasty after a myocardial infarction.
Open surgical techniques with much the same aim are sometimes referred to as atherectomy and this nomenclature has been extended to a wide range of intraluminal devices for performing closed atherectomy via a percutaneous approach. Widening of a vessel may also by achieved by patch angioplasty where a piece of synthetic material be incorporated into a longtitudinal incision.
Closed intravascular devices such as the xenon-hydrogen chloride excimer laser [1] (eg Spectranetics excimer laser), directional and bidirectional atherectomy devices (eg SilverHawk atherectomy device)[2], orbital atherectomy devices, (eg CSI DiamondBack 360)[2], rotational atherectomy devices (eg Pathway Jetstream, Rotablator device) [3], Simpson Coronary AtheroCath[4] and the transluminal extraction catheter[5] have been tried, often to supplement ballon angioplasty in difficult cases. In the past radio frequency angioplasty has also been tried[6].
References
- ↑ Shammas NW, Coiner D, Shammas GA, Christensen L, Dippel EJ, Jerin M. Distal embolic event protection using excimer laser ablation in peripheral vascular interventions: results of the DEEP EMBOLI registry. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists. 2009 Apr; 16(2):197-202.(Link to article – subscription may be required.)
- ↑ a b Shrikhande GV, McKinsey JF. Use and abuse of atherectomy: where should it be used? Seminars in vascular surgery. 2008 Dec; 21(4):204-9.(Link to article – subscription may be required.)
- ↑ Dormal PA, Afrapoli AH, Devaux P. Rotablator: a forgotten tool in limb ischemia? Acta chirurgica Belgica. 2005 Apr; 105(2):231-4.
- ↑ Kushner FG, Helm MJ. Successful directional atherectomy of eccentric renal artery stenosis using the Simpson directional coronary atherocath as a primary therapy. Catheterization and cardiovascular diagnosis. 1993 Jun; 29(2):128-30.
- ↑ Pornratanarangsi S, El-Jack SS, Webster MW, McNab D, Stewart JT, Ormiston JA, Ruygrok PN. Extraction of challenging intracoronary thrombi: multi-device strategies using guide catheters, distal vascular protection devices and aspiration catheters. The Journal of invasive cardiology. 2008 Sep; 20(9):455-62.
- ↑ Saito S, Arai H, Kim K, Aoki N. Initial clinical experiences with rescue unipolar radiofrequency thermal balloon angioplasty after abrupt or threatened vessel closure complicating elective conventional balloon coronary angioplasty. Journal of the American College of Cardiology. 1994 Nov 1; 24(5):1220-8.
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