Percutaneous Transluminal Coronary
Angioplasty (PTCA) is a minimally invasive procedure
to open up blocked coronary arteries, allowing
blood to circulate unobstructed to the heart
muscle.
The procedure begins with the doctor injecting
some local anesthesia into the groin area and
putting a needle into the femoral artery, the
blood vessel that runs down the leg. A guide
wire is placed through the needle and the needle
is removed. An introducer is then placed over
the guide wire, after which the wire is removed.
A different sized guide wire is put in its place.
Next,
a long narrow tube called a diagnostic catheter
is advanced through the introducer over the
guide wire, into the blood vessel. This catheter
is then guided to the aorta and the guide wire
is removed. Once the catheter is placed in the
opening or ostium of one the coronary arteries,
the doctor injects dye and takes an x-ray.
If a treatable blockage is noted, the first
catheter is exchanged for a guiding catheter.
Once the guiding catheter is in place, a guide
wire is advanced across the blockage, then a
balloon catheter is advanced to the blockage
site. The balloon is inflated for a few seconds
to compress the blockage against the artery wall. Then
the balloon is deflated.
The doctor may repeat this a few times, each
time pumping up the balloon a little more to
widen the passage for the blood to flow through.
This treatment may be repeated at each blocked
site in the coronary arteries. A device called
a stent may be placed within the coronary artery
to keep the vessel open. Once the compression
has been performed, contrast media is injected
and an x-ray is taken to check for any change
in the arteries. Following this, the catheter
is removed and the procedure is completed.
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