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Angioplasty - a modern method of treating coronary heart disease

Pathologies of the cardiovascular system occupy a leading position in the diagnosis, as well as often become the cause of death. Angioplasty allows in a short time to solve the problem of narrowed vessels. As a result, the patient quickly recovers and for a long time does not need maintenance therapy.

Content

The essence of surgical intervention

Under the influence of age-related changes in a person lipid metabolism is disturbed. As a result, doctors diagnose atherosclerosis of a chronic nature. The disease tends to leave cholesterol deposits on the inner walls of blood vessels. Due to this, the coronary arteries narrow and the blood supply to the myocardium is disrupted. To prevent complete overlap of the artery, doctors recommend performing angioplasty. This method of surgery is aimed at expanding a constricted or occluded vessel.

According to WHO, there is a tendency to an annual increase in the number of patients with an established diagnosis of coronary heart disease. In half of the clinical cases, if medical treatment or surgery is not performed, death occurs.

Atherosclerosis

In atherosclerosis, cholesterol deposits form on the inner walls of blood vessels.

The operation is performed by an interventional radiologist or X-ray surgeon. In severe cases, stenting is performed in conjunction with angioplasty. The essence of the method of surgical treatment is to identify the affected area and the subsequent introduction of a balloon catheter into it. Angioplasty is performed through a small incision of the skin. When the instrument reaches the desired location, the balloon is gradually inflated, expanding the vessel and restoring blood circulation.

Balloon Angioplasty with Stent

The process of expansion of the narrowed vessel by the method of angioplasty

After angioplasty, the lumen thickness returns to normal, the patient does not observe signs of angina pectoris, he is allowed to do physical exercises. In 95% of cases, the operation is successful and recovery occurs, and the results are saved for several years.

The presented method is not able to cure the disease, it acts only as a way to eliminate the effects of ischemia. Given that the elasticity of the pathological vessel is broken, it may narrow again in a short time. To prevent this, doctors install a metal stent on an ongoing basis.

Angioplasty is performed regardless of the location of the narrowed vessel. It is also performed on the lower limbs.

What is atherosclerosis - video

Advantages and disadvantages of angioplasty

Before agreeing to perform the operation, patients carefully weigh the pros and cons of the intervention.

Advantages of angioplasty:

  1. Restoration of normal blood supply to the vessels.
  2. Improving the lives of patients diagnosed with coronary heart disease.
  3. Preventing heart attacks or strokes.
  4. Reduced risk of heart attack.
  5. The operation is closed.
  6. The duration of the intervention does not exceed two hours.
  7. The rehabilitation period is short.
  8. The cost of maintenance medication is reduced.

Patients on the note! Angioplasty is a procedure after which complications develop in a maximum of 7% of people, the death rate in the process is 1%, the result remains for a long time.

Among the disadvantages are:

  • probability of re-narrowing of the vessel;
  • risk of developing chronic kidney disease;
  • high cost of operation.

In addition, the intervention is permitted to patients no older than 75 years.

Thus, before deciding on surgical treatment, the patient must realize that the operation is fraught with risks, but with a successful outcome, the quality of life improves.

Indications and contraindications for the operation

Percutaneous dilation of the vessel walls is recommended for each patient with a diagnosis of coronary heart disease. Acceptable balloon angioplasty at the time of a heart attack. This will reduce the degree of damage to the middle heart layer.

Contraindications to performing the intervention are:

  1. Diagnosed chronic renal failure.
  2. Persistent, uncontrolled high blood pressure.
  3. Impaired blood coagulation.
  4. Infectious diseases in the acute stage.
  5. The inflammatory process, localized on the inner lining of the heart.
  6. The likelihood of allergic reactions with the introduction of a contrast agent.
  7. Detection of non-cardiovascular diseases
    Pulmonary edema

    Contraindication to angioplasty is pulmonary edema.

    .
  8. Pulmonary edema.
  9. The decrease in potassium in the blood plasma.
  10. Glycoside poisoning.

To identify contraindications conducted a thorough medical examination of patients, including the delivery of the necessary tests.

Preparing for surgery

Before deciding whether to perform a surgical procedure or not, the patient is necessarily placed in a hospital. Under these conditions, he must undergo a complete examination, including physical examinations from doctors and delivery of biological materials for laboratory or instrumental analyzes.

The main diagnostic method is angiography, during which the doctor makes a puncture in the area of ​​the hip and wrist, and then introduces a medical guide.

Note! During the procedure, the patient does not feel any pain.

At the next stage, when the conductor has reached the designated place, a contrast agent is injected through it. Thanks to him, the doctor clearly sees the condition of the affected artery and the exact location of the narrowing or blockage of the canal. According to the results of the diagnosis, the doctor will tell you if surgery is needed and what type of angioplasty is best performed.

If necessary, the patient is prescribed a duplex scan or computer angiography. On the appointed day, and preferably at least 8 hours before the start of the operation, the patient is not recommended to take food, water and medicines. The decision to cancel specific drugs is taken only by the attending physician, which is due to the likelihood of a decrease in the therapeutic effect if you cancel or skip the medication.

Transluminal, balloon, coronary, percutaneous, laser and other types of angioplasty

In medicine, there are three types of operations:

  • transluminal (balloon, coronary, percutaneous) angioplasty - the procedure involves the introduction of a balloon catheter along the length of the affected artery prior to the beginning of the narrowed area, after which the balloon is carefully opened. The operation is considered benign;
  • subintimal angioplasty is an operation during which it is possible to move the balloon through the long sections of the narrowed arteries, which is caused by the penetration of the conductor between the plaque and the wall of the artery;
  • laser angioplasty - intervention is performed by using a laser beam that conducts a quartz filament with the bloodstream, which destroys the cholesterol plaque by exposing the barrier to high temperatures.

The latter method is one of the most benign and progressive, but not cheap.

The operation is allowed only in a special, technically equipped chamber. The process is monitored using x-ray apparatus.

Stages of Angioplasty

The task of angioplasty is to expand the narrowed portion of the vessel or artery with a balloon. To solve it, the specialist consistently performs a number of manipulations.

  1. Conductor transportation in a closed area. To do this, take a medical conductor, made of metal and having a special sliding coating. It allows the instrument to find the smallest areas of the lumen in the atherosclerotic plaque and move into the free part of the artery. The first stage is considered the most difficult in technical terms, only a highly qualified doctor can cope with it.
  2. Transporting the balloon catheter and performing angioplasty. After the conductor has penetrated to its destination, a balloon is guided to it (covered with a slip-enhancing material). After that, an apparatus is connected to the catheter, which inflates the balloon, thereby increasing the lumen of the affected area.

    When the plaque has almost completely closed the lumen of the canal, the doctor decides on the phased use of cylinders of several diameters.

    balloon angioplasty

    Installing a balloon catheter at the site of atherosclerotic plaque formation

  3. Deciding whether to install a stent. In those situations where areas of the deformed plaque are not pressed against the walls of blood vessels, the normal blood flow is disturbed. To strengthen the walls, the surgeon installs a stent. It travels the same path as the balloon and expands at its designated location.
    stent

    The stent is installed to fix the vessel walls.

Angioplasty with stenting of arteries and vessels

A stent for a vessel is a medical instrument resembling a metal mesh tube. It is installed after performing angioplasty. This is necessary in the event that the vessel has lost the ability to hold its true form in order to prevent a rapid contraction, as well as to press down detached plaques.

This design is used when conducting operations on large vessels.

Thanks to advanced technologies, developers create durable nickel-titanium stents. They have two main advantages: independent disclosure and shape memory. Due to this, it is possible to imitate the natural clearance in the channel.

Medical stent

A stent for performing angioplasty and preserving vessel lumen

When performing angioplasty, the stent is put on the balloon. When it expands, the metal structure opens and instantly removes the narrowing of the vessel.

Manufacturers produce several types of stents. To prevent the formation of scars using the product with a drug coating. If necessary, aneurysm therapy preference remains with stent-grafts.

Conducting balloon angioplasty with stenting - video

Postoperative period

After the surgery, the patient is moved from the operating room to the intensive care unit. The first 24 hours are monitored with an ECG device. The doctor regularly examines the site of the incision, and the nurse measures blood counts.

Attention! The patient is forbidden to bend the limb in which the puncture was made.

To stop bleeding, the incision site is covered with a tight bandage and a load is applied. The time spent in the clinic depends on the speed at which the bleeding stops from the vessel. Getting out of bed is allowed only one day after the intervention.

The entire recovery period takes an average of 7 days. During the month is not recommended to drive and lift weights.

Consequences and possible complications

In 95% of cases, the operation is successful, but the risk of complications does exist. The most dangerous is the sudden narrowing of the coronary artery in the first hours after surgery. This happens for several reasons:

  1. Internal arterial wall ruptured.
  2. A thrombus formed at the site of the balloon opening.
  3. A spasm occurred at the site of impact.

In most cases, the development of such complications are subject to:

  • women;
  • patients with myocardial infarction;
  • patients with unstable angina.

To prevent the formation of blood clots, before the operation and after it, the doctor prescribes aspirin. The drug reduces the level of blood clotting.

Aspirin

Aspirin prevents blood clots

Much less common such complications:

  • stroke during angioplasty in the carotid artery;
  • severe bleeding that may open at the site of the catheter;
  • development of myocardial infarction;
  • heart failure;
  • allergic reactions;
  • infection;
  • violation of the integrity of blood vessels.

Given the degree of complexity and high efficiency of the operation, we can say that surgery is almost safe.

Patient Reviews

Patients who have undergone angioplasty, leave positive feedback about the procedure.

My grandmother, who is already 85 years old, was prescribed a coronary angioplasty after a heart attack. The first operation was through the arm, the second - through the groin. Even at this age, the grandmother underwent 2 operations, which not only saved, but extended her life.

Olga

http://otzovik.com/review_2322770.html

My husband's coronarography was done after a heart attack. Throughout the operation, he was always conscious and engaged in a dialogue with the surgeon. So they inserted the catheter, then the contrast, set and expanded the balloon. In this way, the life of my beloved person was saved.

Galina

http://otzovik.com/review_2314728.html

Coronary angioplasty is coronary stenting. Did it twice. Many years have passed .. More fear than necessary. The first time was panic, the second time was calm. Do not be afraid. A small puncture in the thigh under local anesthesia, a catheter is inserted with a balloon, vessels are checked (if you are allergic to iodine, be sure to warn!) And a stent is installed. The hardest thing is to lie down for two days, without getting out of bed or bending your leg. After you can walk, but the first days do not sit down. After installing the stent, you will not be detained for a long time in the hospital, but it is better to rest in a sanatorium. Angina leaves, but in order not to repeat with other vessels like this, you have to drink Plavix for a year (without a substitute for an analogue), constantly drink statins and be seen by a cardiologist. Life becomes much easier! Do not be afraid!

Irima

https://otvet.mail.ru/question/64442487

My husband has ischemic heart disease, had a heart attack a year ago, 42 years old. On December 23, balloon angioplasty and stenting on one vessel was carried out at the Tyumen Cardiology Center (75% was clogged). There was no improvement in well-being. The husband complains of oppressive pains more often than before, more often there is shortness of breath, with severe frosts it feels hard in the cold. We take all prescribed drugs (Concor, Prestarium, Arifon-Retard, Cardiomagnyl, Plavix, Torvakard).

Irina Lyakhovskaya

https://health.mail.ru/consultation/471/

Under the conditions of modern medicine and thanks to angioplasty, specialists restore the lumen of a blocked channel, regardless of the location of the affected area: from the hematopoietic system to the lower extremities. However, patients should remember that surgical treatment eliminates only the unpleasant consequences of severe heart disease. Therefore, it is important to undergo preventive check-ups in a timely manner with a cardiologist and carry out the prescribed treatment.

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