Categories
Uncategorized

Angioplasty

Angioplasty is commonly used to describe the inflation of a balloon within the coronary artery to crush the plaque into the walls of the artery. 

An inverse relationship between mortality and the annual number of angioplasty procedures performed in a hospital.

Hospitals that performed a large number of primary angioplasty procedures were more likely to use aspirin, B-blockers and heparin in the first 24 hours of an myocardial infarction.

There is an inverse relationship between hospital primary angioplasty volume and mortality in patients with ST segment elevation MI (STEMI) (Canto JG).

National Registry Myocardial Infarction data analysis between 1994 in 1998 revealed that a higher primary angioplasty volume hospitals with greater than 33 procedures per year had a 28% lower in hospital mortality compared with low volume hospitals (Canto JG).

Contemporary studies in patients with STEMI analyzing 29,513 patient’s who underwent primary angioplasty indicated that compared with low and medium volume centers high volume centers had a better median door to balloon times, more use of evidence based therapies, but no improvement in length of stay or mortality(Get With The guidelines Steering Committee and Investigators).

The use of balloon angioplasty was limited by abrupt vessel closure due to dissections and restenosis.

Angioplasty carried out shortly after an MI has a risk of causing a stroke.

 

The mortality rate during angioplasty is 1.2%.

 

Sometimes chest pain can occur during angioplasty because the balloon briefly blocks off the blood supply to the heart. 

The risk of complications with angioplasty is higher in:

 

 

People aged 65 and older

 

 

People who have kidney disease or diabetes

 

 

Women

 

 

People who have poor pumping function in their hearts

 

 

People who have extensive heart disease and blockages

Restenosis occurs in 30-40% of patients within 6 months after balloon angioplasty and in 20-30% of patients after angioplasty followed by stenting.

Percutaneous coronary balloon revascularization has a lower success rate and higher stenosis rate in small coronary artery than in larger vessels.

Warfarin before coronary angioplasty with a target INR of 2.1 to 4.8 leads to the lowest event rate, without an increase in bleeding episodes.

 During follow-up, optimal anticoagulation is associated with a decrease in the incidence of late events by 67% and a significant improvement in 6-month angiographic outcome.

Comparison of angioplasty and medical therapy for coronary artery disease reveal that angioplasty improves exercise performance and reduces coronary symptoms to a greater extent than standard medical therapy, but may be associated with a slightly increased rate of major cardiac events such as myocardial infarction and death.

Has advantages compared to thrombolysis which include higher recanalization rates, immediate verification of procedural result, provides information about left ventricular function, and superior survival and reinfarction rates.

The American College of Cardiology/American Heart Association recommends primary angioplasty in patients with STEMI be conducted by laboratories performing at least 36 primary angioplasty Z. year, as well as 200 total angioplasty to a year (Antman EM).

Leave a Reply

Your email address will not be published. Required fields are marked *