Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
What year is the year for which CABG was no longer the only alternative to medicine for the treatment of CAD? Also the year Pam was married
|
1977
|
|
|
What does PTCA stand for?
Also POBA |
Percutaneous transluminal coronary angioplasty
Plain old ballon angioplasty |
|
|
What is a PTCA?
|
Alternative to CABG-which the NARROWED portion of the artery can be enlarged SELECTIVELY without surgery by a ballon to open blocked artery
|
|
|
What does PCI stand for?
|
percutaneous coronary Intervention
-balloons-stents-cutters, grinders |
|
|
Intervention
|
A technique for remodeling a blood vessel throught the introduction of an expandable stent, balloon cathater, or other speialized tool for treating disease
|
|
|
Average hosptal stay after performing stent palcenment-if no complications occur
|
only one more day so thats 2 days
|
|
|
How balloon angioplasty works
Disruption of plaque and arterial wall |
The inflated balloon exerts pressure against the plaque and arterialwall, causing fracturing and splitting a plaque
|
|
|
where does concentric lesions fracture and split?
|
At the vessels thinnest and weakest point
|
|
|
Where does eccentric lesions split?
|
At the junction of the plaque and the arterial wall
|
|
|
What during this the procedure might result in a larger lumen
|
Dissection or seperation of the plaque from the medial wall results in a larger lumen
This is the majopr effective mechanism of balloon angioplasty |
|
|
Balloon dilation causes stretching and thinning of the _____________ wall of the artery
|
medial
|
|
|
What will stretching of the medial wall cause?
|
It will cause it to loose its elastic property
|
|
|
What effects the degree of elastic recoil loss?
|
Balloon to artery size ratio
|
|
|
About how long does it take for there to be renarrowing of the artery as a result of elastic recoil
|
About 1-6 weeks
|
|
|
What would help prevent the renarrowing of an artery
|
Placement of a stent in the artery
|
|
|
what would shear pressures casue?
|
Denudation or stripping of endothelial cells and extrusion or pushing out of plaque components
|
|
|
There may be moldong of _____, but this effect accounts for a small part of the opverall effect of angioplasty
|
softer lipid material
|
|
|
Mechanism of stents
Stents scaffold the _____ and _______ open. |
lumen
plaque |
|
|
Stents hold back ____________flaps and stop
________ and renarrowing of the lumen |
dissection
recoiling |
|
|
PCI Indications
|
Angina pectoris-despite optimal medical therapy
Mild anginapectoris w/ objective evidence of ischemia (abn stress test) High grade lesion of a vessel supplying large area of the myocardium (>70%) |
|
|
PCI Indications
|
AMI as primary therapy or have persistant ischemia or failed thrombolytic therapy
Angina pectoris after CABG Restenosis after successful PCI |
|
|
PCI Contraindications
|
– 1) Unsuitable coronary anatomy.
– 2) Extremely high-risk coronary anatomy in which closure of vessel would result in patient death. – 3) Contraindication to CABG surgery (however, some patients have PCI as their only alternative to revascularization). – 4) Bleeding diathesis. – 5) Patient noncompliance with procedure and post-PCI instructions. – 6) Multiple PCI restenosis – 7) Patients who cannot give informed consent. |
|
|
PCI complications
|
• 1) Death (<1%)
• 2) MI (<3-5%) • 3) Emergency CABG surgery (<3%) and abrupt vessel closure (0.8%). • 4) All the complications that can occur during a cardiac cath; access site bleeding is more common. • Although no a true complication, restenosis, intimal hyperplasia at the site of PCI, occurs in about 10-30% of patients after placement of a stent, leading to recurrence of anginal symptoms. • Typically, restenosis occurs in the initial 6 months after PCI. • In-stent restenosis is expected to be <10% with drug-eluting stents. |
|
|
PCI Equipment
|
THe guiding catheter
ballon, stent, or atherectomy catheter coronary guidewire |
