What is the guidewire traversal test? The guidewire traversal test is a medical procedure used to assess the ability of a patient’s coronary arteries to accommodate interventional devices, such as guidewires and catheters, during cardiac catheterization. During this test, a guidewire is carefully threaded through the coronary arteries to evaluate their size, tortuosity (curvature), and …
Endovascular treatment techniques If a wire cannot be passed through the lumen of a vessel because of chronic total occlusion, what techniques may be used to allow for endovascular treatment? Subintimal recanalization may be performed. This is a technique that uses a catheter and hydrophilic guidewire to traverse the intima of the vessel adjacent to …
What is an atherectomy device, and what types of lesions might it be useful for? Atherectomy devices are endovascular tools that cut or ablate atherosclerotic plaque away from the wall of the diseased artery in an effort to expand the flow lumen. There are currently four types of atherectomy devices: directional, rotational, orbital, and laser. …
Basic principles of thrombolysis procedure What are the basic principles in performing a thrombolysis procedure? Catheter-directed pharmacologic thrombolysis therapy consists of the delivery of a lytic agent directly into a thrombosed vessel or graft. The catheter is largely responsible for instilling the lytic agent only within the thrombosed segment so that relatively small overall doses …
What is the kissing balloon technique in angioplasty? This technique is most commonly used to perform angioplasty of the common iliac arteries. Often, stenoses of the proximal common iliac arteries are associated with large, eccentric, calcified plaques. Sequential, as opposed to simultaneous, angioplasty may displace the plaque and lead to compromise of the contralateral iliac …
What constitutes a hemodynamically significant arterial stenosis? A stenosis is generally considered significant if the luminal diameter is reduced by 50%, and the systolic pressure gradient is greater than 10 mm Hg across the lesion. A lumen that is diminished by 50% would have a corresponding 75% reduction in cross-sectional area, which would likely reduce flow to …
What are the indications for stenting? Primary indications for stenting include failed angioplasty caused by a flow-limiting dissection or elastic recoil of the stenosis. The lumen of a stented segment will narrow somewhat over time due to pseudointimal proliferation. Therefore, stents work better in larger caliber arteries. However, recent studies have demonstrated that stents may …