Circularization Endarterectomy Essay

The blood vessel that Dr. Eltahawy was concerned about was thin and looked as though it would collapse in on itself. First, Dr. Eltahawy tried a balloon catheter. At the top of the catheter was a small balloon that could inflate to maintain a shape or structure of a blood vessel. However, because the blood vessel was so thin, the balloon catheter was not very effective. Instead, Dr. Eltahawy installed a stent. A stent is a wire mesh tube. It is placed in a blood vessel permanently to maintain the shape of the vessel and to allow for the free flow of blood. Throughout this entire independent study, I realize that shadowing in the medical field is less about learning about medicine and more about discovering about whether becoming a doctor is the right step. This independent study has been a step in the right

Heart disease is a complication associated with diabetes. When it comes to procedures such as bypass, surgery, angioplasty and stents, it is usually presumed that the least invasion option is the best. Discover the truth behind this presumption and why it might not always be the case for those with diabetes.

Cerebrovascular accidents, or strokes, will lead to brain damage that affects the functioning of executive function, memory, language, visuospatial performance and emotional states. Corresponding vertebral arteries and carotid arteries provide blood to the brain from the heart that the carotid arteries are internal and external sections of the thyroid cartilage. Where the optic nerve rests the internal artery distributes into the anterior and middle cerebral arteries. The vertebral arteries arise through the spinal vertebrae and meet the lower pons to form the basilar artery. The brain receives 15% to 20% of the oxygenated blood from the heart and can only endure fleeting interruptions of blood flow before neural operations

A stent definitely would have helped in general, but they wanted to avoid it since it would cause the man’s insurance to go up as he would be a higher risk. It was interesting to see how much thought goes into every decision and how it isn’t always related to just the medical side of it. Reichard had another surgeon come in and do a test where they measure the pressure on both sides of the blockage to see if a stent was actually necessary. They cutoff point they were looking for was about .85, any lower and they would put a stent in during his next procedure. It ended up being .91. This second test was important not only because it prevented a stent that wasn’t totally necessary, but it also allowed the man to be eligible for some procedures that he may not have been if a stent was placed. Another interesting angiogram case was on an older woman who most likely needed a replacement of her aortic valve. The aortic valve is usually the size of a quarter, but through initial imagining it was clear that hers was more the size of a pea. However, they wanted to verify this data through an angiogram where they measured the pressure drop-off from before to past the

2013). Nevertheless, Percutaneous transluminal angioplasty and Bare-metal stents failed to demonstrate durability because of the high rate of restenosis following endovascular procedure which could occur early after treatment (Falkowski et al. 2009)

This has the effect to produce contrast between vascular structures and surrounding soft tissues. Depending on the timing of imaging after IV injection arteries veins or soft tissues are highlighted. For the purposes of acute evaluation of stroke as is described above an initial non contrats CT scan is performed , followed immediately afterwards by a CT angiogram to evaluate vascular structures from aortic arch to the vertex. This technique is very accurate for diagnosing occlusion of any of the cerebral arteries be they intracranial or extracranial. It will also diagnose the presence of stenosis or dissection of the carotid arteries or middle cerebral arteries. From these images reconstructions of intracranial and extracranial cerebral arteries can be made. A contrast enhanced cerebral angiogram is essential for the planning of thrombectomy as it will provide precise anatomy of cerebral arteries, any stenosis or thrombus in each

TAVR is an effective choice to combat stenosis. According to a study done by Samir

Some lifestyle-related conditions and decisions increase the likelihood of a person having heart disease. Some examples are diabetes, overweight and obesity, poor diet, lack of physical activity and excessive consumption of alcohol. High blood pressure, low-density lipoprotein (BAD) cholesterol, and smoking are key risk factors for heart disease. LBD is considered to be "bad" cholesterol because having high levels can lead to accumulation in the arteries, which can cause heart disease and stroke. If you lower your blood pressure and cholesterol, and if you do not smoke, you will reduce your chances of having heart disease. Now, in case of emergency, angioplasty which is the best treatment needs to get done. In this case we need to kake in consideration that not all hospitals are capable to made the process, so we need to be aware of our options. After the angioplasty you should take a daily medication, which will help your heart adapt to the implanted stents and they will not close again, a phenomenon known as restenosis, his medication should not be forgotten any day in order to minimize future

Aneurysms, localized enlargements of artery walls, can be treated through unassisted endovascular coiling or stent assisted endovascular coiling (BA Foundation, n.d.). Although the treatment methods are effective, their durability and ability to prevent aneurysm recurrence are under question. The purpose of this study was to compare the recurrence rates of aneurysms treated with unassisted coiling and stent assisted coiling. I conducted a quantitative meta-analysis study and looked at studies from 2009 to 2017 involving the treatment of aneurysms of different characteristics with stent assisted coiling method or unassisted coiling method.

There are many new technologies and advancements within the cardiovascular community. These technologies and advancements happen frequently and are to help better the equipment for better outcomes for patients treated. One of the new technologies that has made great strides is the orbital atherectomy. Orbital atherectomy is a technology created by a company called Cardiovascular Systems Inc. (CSI). What the new device does is make it easier and safer for balloon and stent administration within a heavily calcified vessel. The ORBIT is a new instrument used during a catheterization procedure that can break up calcified plaque. Patients that have a clogged coronary artery, that is restricting the blood flow to the heart would benefit from the

Once a good position was confirmed, balloon angioplasty was carried out x 1. Conduit angiogram shows improved flow within the LPA stent. However, no significant improving was noticed in the narrowed conduit. Therefore, a Rosen guide wire was exchanged by a 0.35 Amplatz Super Stiff Wire to facilitate stenting of the RV-PA conduit. A pre-mounted 10 mm x 26 mm Valeo stent was tracked over a 0.35 Amplatz Supper Stiff Wire. Once the appropriate position was confirmed, the stent was deployed in the RV-PA conduit. Subsequent pressure measurement revealed improved in the RV pressure ( RV pressure ½ systemic from ¾ systemic). Conduit angiogram was carried out through the long sheath which shows satisfactory position of the stent with good flow in the conduit, RPA, and LPA and no extravasation or stent fracture was

Cerebrovascular circulation is the movement of blood through the central veins and arteries supplying the brain. Blood supply to the brain is very important and with the help of four main arteries that is achieved. Those four main arteries consist of the left and right internal carotid arteries and the left and right vertebral arteries. When there is an area of blockage or plaque formation in these vessels then a problem may occur. Carotid artery disease is common and increases the risk of having a stroke. The collateral circulation is an important aspect affecting the risk of stroke. The cerebral circulation will attempt to maintain constant cerebral perfusion even if there are changes within the system. If one major cerebral artery is occluded,

Atherosclerosis is an inflammatory disease that causes formation of plaques under the intimal layer of the blood vessel wall. As the plaque grows and calcifies, it narrows the blood vessel lumen and decreases blood flow to the downstream tissue. Also, risk of plaque rupture increases. Plaque rupture leads to platelet adhesion that results in a thrombus, which occludes the artery. Occlusion of the coronary arteries results in myocardial infarction. Pathologies affecting small and medium sized arteries are the leading cause of death worldwide. Due to development of better treatments, mortality rates after myocardial infarction have decreased in the last decades (REF). However, replacement of the occluded artery is often necessary. The currently available options for these transplants are limited. The most frequently applied treatment for coronary artery occlusion is a bypass operation. During this operation, an autologous blood vessel (often a saphenous vein or a mammary artery) is used to bypass the coronary artery. The use of these so-called autografts is invasive and may be limited due to previous harvesting and anatomical variability. Furthermore, atherosclerosis is often found in almost all blood vessels of the patient. The risk of occlusion of the autograft is high (Hasan et al., 2014).

appear similar to conventional stents.”8 Middleton, Teefey and Darcy8 note that the use of PFTE endografts will likely become standard as their performance outweighs the early stent materials used. Color Doppler as well as pulsed Doppler should be used to interrogate the stent and supporting vessels. Velocity measurements are taken using angle correct and spectral waveforms are recorded. Careful examination of the liver vasculature is imperative to verify proper stent function. Specifically, thrombosis or occlusion can be assessed with color and Doppler ultrasound. Velocity parameters may vary from patient to patient and also will change from immediate post procedure velocities to those obtained during long term follow up. Universal Doppler

Tashiro et al (2013) at Mayo clinic reported on 236 severe aortic stenosis patients and 256 controls that underwent non cardiac surgery between 2000