Angioplasty

Angioplasty
ICD-9-CM	00.6
MeSH	D017130

Angioplasty is the mechanical widening of a narrowed or totally obstructed blood vessel. These obstructions are often caused by atherosclerosis. The word is composed of the medical combining forms of the Greek words aggeîos meaning "vessel" and plastós meaning "formed" or "moulded". Angioplasty has come to include all manner of vascular interventions typically performed in a minimally invasive or percutaneous method.

Coronary angioplasty

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.

Main article: Percutaneous coronary intervention

Percutaneous 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

• Angiogram
• Charles Dotter
• Vascular surgery

External links

• Angioplasty.Org, celebrating a decade of independent cardiology news and education
• Cardiovascular and Interventional Radiological Society of Europe
• Cardiovillage, cardiovascular education online
• National Heart Lung and Blood Institute, Diseases and Conditions Index
• Overview Coronary Artery Disease Treatment - Coronary Interventions ANGIOPLASTY, STENTS AND ATHERECTOMY (Cleveland Clinic)
• Detailed chronicle of a cardiac patient's medical care - A real life account of a cardiac patient's experience.