Percutaneous transluminal coronary angioplasty: Difference between revisions

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[[Stent]]ing reduces the rate of restenosis, but should not be done if the patient cannot take [[clopidogrel]], has extensive stenoses, the stenosis is in a very small coronary artery, or if bypass surgery is planned within a few days.<ref name="pmid17202455"/>
[[Stent]]ing reduces the rate of restenosis, but should not be done if the patient cannot take [[clopidogrel]], has extensive stenoses, the stenosis is in a very small coronary artery, or if bypass surgery is planned within a few days.<ref name="pmid17202455"/>


===Drug-eluting stents===
{{Image|Coronary stent.jpg|right|350px|Insertion of the stent on the delivery catheter, expansion of the stent, and lastly appearance after withdrawal of the delivery catheter.}}
<font><small><tt>{{Image|Coronary stent.jpg|right|350px|</tt></small></font>Insertion of the stent on the delivery catheter, expansion of the stent, and lastly appearance after withdrawal of the delivery catheter.<font><small><tt>}}</tt></small></font>
Drug-eluting stents further reduce restenosis compared with bare-metal stents<ref name="pmid16971716">{{cite journal |author=Spaulding C, Henry P, Teiger E, ''et al'' |title=Sirolimus-eluting versus uncoated stents in acute myocardial infarction |journal=N. Engl. J. Med. |volume=355 |issue=11 |pages=1093–104 |year=2006 |month=September |pmid=16971716 |doi=10.1056/NEJMoa062006 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=16971716&promo=ONFLNS19 |issn=}}</ref>, but drug-eluting stents may increase the rate of delayed restenoses. Delayed restenosis may be prevented by taking  [[aspirin]] combined with [[clopidogrel]].<ref name="pmid17202455"/> The drugs eluted are [[sirolimus]] and [[paclitaxel]]. Sirolimus was first approved in the [[United States]] by the [[Food and Drug Administration]] in 2003.<ref name="urlDevices@FDA11506 ">{{cite web |url=http://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm?db=PMA&id=11506 |title=Devices@FDA |author=Anonymous |authorlink= |coauthors= |date=2003 |format= |work= |publisher=Food and Drug Administration |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=2009-05-02}}</ref> Paclitaxel was first approved in the [[United States]] in 2004.<ref name="urlDevices@FDA14019">{{cite web |url=http://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm?db=PMA&id=14019 |title=Devices@FDA |author=Anonymous |authorlink= |coauthors= |date=2004 |format= |work= |publisher=Food and Drug Administration |pages= |language= |archiveurl= |archivedate= |quote= |accessdate=2009-05-02}}</ref>


==Complications==
==Complications==

Revision as of 11:11, 27 May 2009

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In medicine, percutaneous transluminal coronary angioplasty (PTCA), also called percutaneous coronary intervention (PCI), is a form of myocardial revascularization in which occurs "dilatation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply."[1]

PTCA may be a treatment for myocardial infarction and an intravascular stent may or may not be left at the site of the stenosis in order to prevent restenosis.[2]

Stenting

For more information, see: Stent.

Stenting reduces the rate of restenosis, but should not be done if the patient cannot take clopidogrel, has extensive stenoses, the stenosis is in a very small coronary artery, or if bypass surgery is planned within a few days.[2]

Insertion of the stent on the delivery catheter, expansion of the stent, and lastly appearance after withdrawal of the delivery catheter.

Complications

Ventricular dysrhythmia during PTCA for myocardial infarction indicates an increased risk for mortality at 3 months.[3]

References

  1. ↑ Anonymous (2024), Percutaneous transluminal coronary angioplasty (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ 2.0 2.1 Keeley EC, Hillis LD (2007). "Primary PCI for myocardial infarction with ST-segment elevation". N. Engl. J. Med. 356 (1): 47-54. DOI:10.1056/NEJMct063503. PMID 17202455. Research Blogging.
  3. ↑ Mehta, Rajendra H.; Aijing Z. Starr, Renato D. Lopes, Judith S. Hochman, Petr Widimsky, Karen S. Pieper, Paul W. Armstrong, Christopher B. Granger, for the APEX AMI Investigators (2009-05-06). "Incidence of and Outcomes Associated With Ventricular Tachycardia or Fibrillation in Patients Undergoing Primary Percutaneous Coronary Intervention". JAMA 301 (17): 1779-1789. DOI:10.1001/jama.2009.600. Retrieved on 2009-05-06. Research Blogging.
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