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Preparation: To do the test, the right or left groin is shaved
in preparation for the study. The patient is then brought to the
catheterization laboratory and placed on a special x-ray table,
which is fairly well padded and reasonably comfortable. A special
soap is applied to sterilize the right and/or left groin area. The
groin area is covered with a large sterile drape that extends from
around the chin area down below the feet. A cutout in the drape
has been made so that there is access to the femoral artery, which
is just below the skin in the groin area
Procedure:
Lidocaine or a similar anesthetic is injected around the
femoral artery through the skin. This stings or burns a little.
Once the area has been anesthetized, a hollow needle is inserted
through the skin into the femoral artery. A special guiding catheter
is placed inside femoral artery and is then guided into the opening
of one of the heart arteries. You will not be aware of this movement,
as there is no physical sensation or discomfort during this phase.
A guide-wire is then placed inside the catheter and is advanced
into the coronary artery. The physician views the position of the
guide-wire as he/she carefully pushes it up to the blocked artery.
The flexible tip of the guide-wire is gently pushed through the
blocked artery and is stopped slightly beyond the blockage. A tiny
expandable balloon catheter is advanced over the guide-wire and
into the blocked area. The balloon catheter is so small that it
simply slips through the narrowed area without difficulty. Once
the position of the balloon catheter is found to be correct, the
balloon is inflated for around 60 seconds. The balloon is then deflated.
The results are checked by injecting and monitoring the flow of
dye through the artery. If ideal blood flow has been restored, the
balloon catheter is withdrawn and additional pictures are taken.
Careful measurements are made to make sure that the artery is adequately
open. If a proper result is obtained, the guide-wire and guiding
catheter are removed and the procedure is considered complete.
Post Procedure:
The patient is taken to his room and monitored. Several hours later,
the artery sheaths, which were left in the artery while all the
work was going on, are withdrawn. A pressure holding device is placed
on the leg for an hour or so. It is then removed and a bandage is
then placed over the artery insertion site. The patient stays in
bed overnight and starts walking the next morning. Assuming that
everything goes well, the patient often goes home the day after
the (PTCA) angioplasty is done.
At
times, a second artery can be opened with a balloon catheter during
that same procedure, and at other times, this second procedure is
deferred to either the following day or a day or so after. It is
common for stenting to occur in conjunction with angioplasty.
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