Angioplasty, Causes, Signs and Symptoms, Diagnosis and Treatment.

Описание: .

Chapters

0:09 Introduction
0;50 How is it done
1:42 Benefits
2:13 Risks





Angioplasty, also known as balloon angioplasty and percutaneous transluminal angioplasty (PTA), is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis.[1] A deflated balloon attached to a catheter (a balloon catheter) is passed over a guide-wire into the narrowed vessel and then inflated to a fixed size.[1] The balloon forces expansion of the blood vessel and the surrounding muscular wall, allowing an improved blood flow.[1] A stent may be inserted at the time of ballooning to ensure the vessel remains open, and the balloon is then deflated and withdrawn.[2] Angioplasty has come to include all manner of vascular interventions that are typically performed percutaneously.

The word is composed of the combining forms of the Greek words ἀγγεῖον angeîon "vessel" or "cavity" (of the human body) and πλάσσω plássō "form" or "mould". A coronary angioplasty is a therapeutic procedure to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease.[1] These stenotic segments of the coronary arteries arise due to the buildup of cholesterol-laden plaques that form in a condition known as atherosclerosis.[3] A percutaneous coronary intervention (PCI), or coronary angioplasty with stenting, is a non-surgical procedure used to improve the blood flow to the heart.[1]

Coronary Angioplasty is indicated for coronary artery disease such as unstable angina, NSTEMI, STEMI and spontaneous coronary artery perforation.[1] PCI for stable coronary disease has been shown to significantly relieve symptoms such as angina, or chest pain, thereby improving functional limitations and quality of life.[4]
Peripheral angioplasty

Peripheral angioplasty refers to the use of a balloon to open a blood vessel outside the coronary arteries. It is most commonly done to treat atherosclerotic narrowings of the abdomen, leg and renal arteries caused by peripheral artery disease. Often, peripheral angioplasty is used in conjunction with guide wire, peripheral stenting and an atherectomy.[5]
Chronic limb-threatening ischemia

Angioplasty can be used to treat advanced peripheral artery disease to relieve the claudication, or leg pain, that is classically associated with the condition.[6]

The bypass versus angioplasty in severe ischemia of the leg (BASIL) trial investigated infrainguinal bypass surgery first compared to angioplasty first in select patients with severe lower limb ischemia who were candidates for either procedure. The BASIL trial found that angioplasty was associated with less short term morbidity compared with bypass surgery, however long term outcomes favor bypass surgery.[7]

Based on the BASIL trial, the ACCF/AHA guidelines recommend balloon angioplasty only for patients with a life expectancy of 2 years or less or those who do not have an autogenous vein available. For patients with a life expectancy greater than 2 of years life, or who have an autogenous vein, a bypass surgery could be performed first.[8]