Percutaneous transluminal coronary angioplasty
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 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]
Drug-eluting stents
Drug-eluting stents further reduce restenosis compared with bare-metal stents[3], but drug-eluting stents may increase the rate of delayed restenoses. Delayed restenosis may be prevented by taking aspirin combined with clopidogrel.[2] The drugs eluted are sirolimus and paclitaxel. Sirolimus was first approved in the United States by the Food and Drug Administration in 2003.[4] Paclitaxel was first approved in the United States in 2004.[5]
Complications
Ventricular dysrhythmia during PTCA for myocardial infarction indicates an increased risk for mortality at 3 months.[6]
References
- ↑ Anonymous (2024), Percutaneous transluminal coronary angioplasty (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 2.2 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.
- ↑ Spaulding C, Henry P, Teiger E, et al (September 2006). "Sirolimus-eluting versus uncoated stents in acute myocardial infarction". N. Engl. J. Med. 355 (11): 1093–104. DOI:10.1056/NEJMoa062006. PMID 16971716. Research Blogging.
- ↑ Anonymous (2003). Devices@FDA. Food and Drug Administration. Retrieved on 2009-05-02.
- ↑ Anonymous (2004). Devices@FDA. Food and Drug Administration. Retrieved on 2009-05-02.
- ↑ 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.