![]() ![]() Your doctor closes a hole in your heart or stops a leak in a valve. Your doctor takes a small sample of tissue from your heart. When this balloon is inflated, it pushes plaque out and widens your artery. Your doctor inserts a catheter with a tiny balloon at the tip. Procedures that might be done during your cardiac cath include: Your doctor can use cardiac cath to both find and fix problems. Check for heart disease (such as coronary artery disease, heart valve disease, or disease of the aorta).Doctors use contrast dye that they inject into your blood vessel through the catheter to create X-ray videos of your valves, coronary arteries, and heart chambers. During the test, they put a long, narrow tube called a catheter into a blood vessel in your arm or leg and guide it to your heart with the aid of a special X-ray machine. Drug-coated stents tend to be used in patients with a high bleeding risk due to the shorter mandatory duration of DAPT.Cardiac catheterization (also called cardiac cath, heart cath, or coronary angiogram) is a procedure that allows your doctor to see how well your blood vessels supply your heart. Polymer-free drug-coated stents are similar to DES, but lack the polymer layer that binds and elutes the relevant drug in DES. They are completely resorbed over a period of time (usually 18 months to 2 years). Modern DES are associated with low rates of in-stent restenosis and thrombosis.īioresorbable scaffolds (BVS or BRS) perform the same role as a stent in that they provide a scaffold to ensure vessel patency. The choice of which particular DES is used is based on a number of factors (for example, the drug eluted, the deliverability of the stent, the exact size needed or the minimum duration of DAPT required). The principle is to inhibit neointimal hyperplasia and reduce the incidence of restenosis. Modern DES ‘elute’ either zotarolimus or everolimus (both sirolimus analogues, which are immunosuppressants). BMS require a shorter duration of dual-antiplatelet therapy (DAPT), but newer-generation DES allow a shorter period of DAPT to be safely used. Metal stent devices can be either bare-metal stents (BMS) or drug-eluting stents (DES). This can give information on the size and length of stent required, and the type of coronary artery lesion and the current state of any previously deployed stents. Both offer the cardiologist the ability to directly image the coronary artery lumen. Intra-coronary imaging tools include intravascular ultrasound (IVUS) and optical coherence tomography (OCT). IFR (instant free-wave ratio) is an alternative to FFR that does not require maximal hyperaemia. If the FFR is ≥0.80, percutaneous coronary intervention (PCI) is not undertaken, because performing angioplasty in this situation would not benefit the patient. In this investigation, a wire or catheter with a pressure sensor measures the pressure drop across a coronary lesion at maximal hyperaemia, that is, the coronary artery at its maximal size, typically achieved with an infusion of adenosine. The most commonly used technique is fractional flow reserve (FFR), commonly known as a pressure-wire study. Panel B shows a ‘left-dominant’ coronary circulation, in which the PDA arises from the LCx.Ī number of different techniques may be used to assess ischaemia (functional assessment). Panel A shows a ‘right-dominant’ coronary circulation, in which the PDA arises from the RCA. ![]()
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