Balloon Dilatation and Stent Implantation in Coronary Vessels
Expansion of Coronary Vessels (PTCA)
If in your case angioplasty is deployed to remove a cardiovascular constriction the procedure then is usually conducted right after the cardiac examination, though it can take place in a separate procedure. If the expansion can be done in the same session the resting period afterwards will be at least 6 hours long as more blood-thinning medication has to be used and the deployed catheter is not as fine as in purely diagnostic procedures.
Technique
The coronary vessels are shown once more in the usual way. Then a guiding catheter is inserted in the first part of the coronary artery. Through this an elastic and very fine wire is guided past the location of the cardiovascular constriction. The balloon catheter is pushed through to the constriction using the wire like a rail; there the balloon is unfolded by inserting a mixture of contrast agents with high pressure. By overexpansion of the vessel and pressing cholesterol and chalk deposits into the walls of the vessel the constriction is opened up.
About 70% of our patients receive one or more stent implants supporting the vessel and thus improving result and long-term success. This depends on the individual case though and is not always necessary and sensible.
Zu dieser Abb.: PTCA 1) Draht durch Engstelle 2) Ballon entfaltet 3) Stent auf Ballon eingebracht 4) entfalteteter Stent plaziert - heilt binnen 4 Wochen ein
Possible Complications
In about 1-2% of all cases local complications in the area of the puncture can occur such as a large effusion of blood, a vasodilatation (aneurysma spurium), or a so-called AV fistula. Normally these disorders heal without any further consequences.
Rare cases though (0.3% all in all) require surgical treatment.
In up to 1% of the cases (0.25% in Bad Soden) patients might die during or immediately after PTCA. These are usually patients with serious pre-existing heart defects (e.g. acute cardiac infarction). During the procedure a situation can occur that requires an immediate bypass surgery (from the experience in Bad Soden though less than 0.1% of the cases are concerned).
For this reason a surgery team at the Frankfurt University Clinic are on stand-by during dilatation. Though this procedure carries some risks that should not be ignored it has to be noted that it is always far more dangerous not to treat the disease.
