ANGIOPLASTY (1).pptx

PCI

1. CORONARY ANGIOPLASTY OIH 28/02/2022

2. 2 Introduction Until the year 1977, patients diagnosed with significant coronary artery disease could be offered only two treatment options: medical therapy or high-risk coronary artery bypass graft surgery (CABG) On September 16, 1977, after years of experimentation on canine and cadaverous vessels, Dr. Andreas Gruentzig dilated a proximal LAD lesion through a catheter, and so performed the first human percutaneous transluminal coronary angioplasty (PTCA).

3. 3 Indications Indications for PCI include, but are not limited to, the following: Acute myocardial infarction Unstable angina with single or double major vessels disease Acute coronary syndrome Non surgical candidates with multivessel disease

4. 4 CORONARY ANGIOPLASTY Is performed to open blocked or narrowed coronary arteries caused by coronary artery disease (CAD) and to restore arterial blood flow to the heart tissue without open heart surgery

5. 5 Coronary angioplasty The term " angioplasty " means using a balloon to stretch open a narrowed or blocked artery. However, most modern angioplasty procedures also involve inserting a short wire-mesh tube, called a stent, into the artery during the procedure. The stent is left in place permanently to allow blood to flow more freely. Coronary angioplasty is sometimes known as percutaneous transluminal coronary angioplasty (PTCA ) and t he combination of coronary angioplasty with stenting is usually referred to as percutaneous coronary intervention ( PCI) .

6. 6 Coronary angioplasty CATHETER BALLON

7. 7 Coronary angioplasty STENT

8. 8 coronary angioplasty

9. 9 Coronary angioplasty First, a guiding catheter is seated in the coronary ostium of the select coronary artery . A thin, steerable guidewire is introduced into the guide catheter and then into the coronary artery and positioned across the stenosis into the distal aspect of the artery.

10. 10 Coronary angioplasty The guiding catheter will be removed but the guide wire will remain at the place of the lesion .Thought this guide wire , a balloon catheter will be paced at the lesion. The balloon is inflated once the catheter has been placed into the narrowed area of the coronary artery

11. 11 Balloon angioplasty

12. 12 Stenting Almost all the cases the use of a balloon catheter will be follow by the implantation of the stent. A tiny , expandable metal coil ( stent) is inserted into the newly opened area of the artery to help keep the artery from narrowing or closing again

13. 13 Stenting

14. 14 Stenting

15. 15 Coronary angioplasty The inflation of the balloon compresses the fatty tissue in the artery and makes a larger opening inside the artery for improved blood flow. Catheter will be removed an contrast inject .

16. 16 LAD angioplasty

17. 17 Right coronary Angiosplaty

18. 18 Risks of procedure Bleeding at the catheter insertion site (usually groin) Blood clots or damage to the blood vessels at the insertion site Blood clot within the vessel treated by PTCA/stent Infection at the catheter insertion site Cardiac arrhythmia Chest pain or discomfort Rupture of coronary artery

19. 19 After procedure When the patient returns to the ward or department following the procedure, cardiac monitoring should be commenced to detect any arrhythmias, and the patient should be observed for signs of chest pain. A 12-lead electrocardiogram should be recorded to identify any changes which could indicate the presence of ischemia or stent occlusion. Observations of blood pressure (BP), heart rate, respirations and temperature should be recorded at a frequency recommended by medical order .

20. 20 AFTER PROCEDURE The limb/arm that has been used for the procedure needs to be closely monitored for signs of poor arterial circulation. Colour and warmth of the limb/arm should be checked. Pulses, distal to the puncture site, should be monitored at regular intervals to ensure adequate blood flow. Also important observe the puncture site itself for signs of hematoma or bleeding Patients may experience pain from the puncture site and discomfort from their prolonged period of immobility, so analgesia may be required.

21. 21 Conclusion Percutaneous coronary interventions are a reasonably safe and effective treatment for patients experiencing the symptoms of coronary heart disease. It is more affordable, requires fewer resources and is less traumatic than coronary artery surgery.

22. THANK YOU شكراً 22 Isabel Paulo