Unit 1 Intravascular Angiography

Atherosclerosis is the process in which substances known as plaques, which are made up of cholesterol and platelets, adhere to tears in the walls of arteries. Over time these plaques build up to the point where they occlude blood flow in the arteries. When this happens in the coronary arteries, either directly, as the result of buildup in the arteries themselves, indirectly in the form a clot from another part of the body breaking loose and becoming lodged in the coronary arteries, the usual result is a heart attack.3

The following summary is an updated case study of a 47 year old male patient, Jim who was diagnosed with Coronary Artery Disease. The patient did receive information on what CAD is and was informed that test were needed to fully diagnose and be evaluated for underlying conditions (high blood pressure, high blood cholesterol levels, diabetes and blockage. I will discuss the type of test needed for this condition and tests for any underlying conditions that are related to this disease. The type of treatment needed to control and lower his risk factor. I will also give the patient information about complementary and alternative medicine so the patient will be well informed about different types of treatment. The patient will be informed about the prognosis of the disease, and the options that the patient has to succeed in the changes in his lifestyle that are needed.

Coronary Artery Disease, also known as CAD, is the most common form of heart disease. (Heart and Stroke Foundation, 2009) Coronary Artery Disease obstructs the blood flow in vessels that provides blood to the heart which is caused by the buildup of plaque on the artery walls. (Rogers, 2011, p.87) (Heart and Stroke Foundation, 2009) Plaque is a yellow substance that consists of fat substances, like cholesterol, and narrows or clogs the arteries which prevents blood flow. (Heart and Stroke Foundation, 2009) Plaque can build up in any artery but usually favors large and medium sized arteries. (Heart and Stroke Foundation, 2009)

A coronary angiography provides information about the hearts blood pressure and functioning. This procedure can identify whether the coronary arteries are blocked or narrowing. A tube/camera is passed through an artery in the groin or arm; it is guided using x-rays up to the heart. A coronary angiogram is a safe procedure, but there are some small side affect. You may feel a slightly strange sensation when the dye is put down the catheter, a small amount of bleeding when the catheter is removed, a bruise in your groin or arm.

ngiography is a test used to detect blockages of the arteries or veins. It is

Usually, accessing vascular structures is done through a needle to puncture the vessel percutaneously, followed by a wire introduced through the needle to secure the vascular access. The needle is then removed and a sheath is advanced over the wire. Vascular sheaths are hollow structures with a built in diaphragm to prevent bleeding. Catheters are then placed into and out of the sheath with a minimal loss of blood.11

The obstruction in Room 40’s leg was discovered using a diagnostic arteriogram. An arteriogram is an image of the interior of blood vessels, such as arteries, by the use of electromagnetic waves. During this procedure, a dye is injected into the artery revealing any bulges, weakness, lesions or occlusions of the blood vessel. The ability to see any evidence of a a plaque formation or obstruction within a vessel makes an arteriogram an effective method for detecting atherosclerosis (Johns Hopkins Medicine, 2015).

Angiograms are for diagnostic purposes so in the x-ray imaging one would look for a narrowing of the artery/vein. The x-ray moves takes 2-5 second videos from five different angles of the heart. During this time they surgeon and those in the control room look for any potential plaque blockages where the vessel becomes restricted and the color of the dye is not as dark. Of the eight angiograms five needed stents or valve replacements. They also pump a large amount of dye into the left ventricle of the heart to see the strength at which it is pumping. The first angiogram procedure I saw was on this 350lb man who was having heart arrhythmias and through this procedure they were able to determine that there was a 70% blockage in one of his arteries. However, Dr. Reichard wanted to do further investigation to see how much blood was getting through to determine if

Coronary illness is the development of plaque (fat store on the inward dividers of the veins) in the coronary conduits that supply O2 rich blood to the heart muscle, the development of plaque is called atherosclerosis. After some time passes plaques may solidify therefore limiting blood stream or totally obstructing the corridor. The development of plaque is straightforwardly identified with a people way of life, normal danger elements incorporate stoutness, high blood cholesterol and diabetes. At the point when the endothelium is harmed by blood stream, the cholesterol and fats in the blood get stuck shaping plaques. This outcomes in hypertension due the heart endeavoring to supply obliged levels of blood to the body. In the event that the blood stream to the heart muscles is limited or blocked it may

Sometimes atherosclerosis occurs in the carotid arteries, especially at the bifurcation or the point where the common carotid divides into the internal and external carotids. Atherosclerosis means that a potentially dangerous plaque has formed on the artery wall. Plaque is a sticky material made of fat and calcium which hardens the arteries and can block the flow of blood. This narrowing is sometimes called a carotid artery stenosis, meaning that the carotid artery has narrowed significantly.

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

1. Angioplasty: Kereiakes and Wetherill write that “angioplasty is a procedure in which a heart doctor inserts a balloon catheter over a thin wire across an artery. The balloon is inflated and compresses the plaque to clear the arteries of any blockage.”(p. 106-107).

Mr. Harry Bright has undergone a procedure called percutaneous transluminal coronary intervention (PTCI) via a femoral approach for the treatment of his progressive unstable angina. Femoral artery is the most common access site used for PTCI because of its size and its direct passageway to the heart (Young, 2014 p.431; Cosman, Arthur, Bryant-Lukosius, Strachan, 2015 p.180). In this procedure, a cardiac catheter followed by a stent is inserted into the artery to dilate the occluded blood vessel and improve blood flow (Young, 2014 p.430). The occlusive atherosclerotic plaque is usually associated with Mr. Bright’s diabetes, hypertension and smoking history. Contrary to the positive effect of PTCI, bleeding and hematoma formation are the most

According to the World Health Organization 2002 survey , 7.2 million people died due to coronary heart disease(CHD).The Intravascular ultrasound (IVUS) is one of the most commonly-used interventional imaging techniques because it allows direct visualization of stenotic coronary arteries and accumulated plaques and morphology. During coronary syndrome (CS) diagnosis the inner and outer coronary plaque boundaries in the IVUS image have to be detected for evaluating the quantitative assessment of the coronary plaque compositions. Currently, these coronary plaque boundaries are manually drawn and the area of that plaque is also evaluated manually by a medical doctor. After that, the volume of the plaque is estimated by integrating the calculated

The intravascular ultrasound (IVUS) method is a catheter based medical imaging technique that produces the cross-sectional images of blood vessel and useful for the diagnosis of atherosclerosis[6][7]and this method used in the coronary arteries to observe within the blood vessel all the way through to the surrounding blood column. Used to visualizing the coronary plaque, determining the amount of plaque built up at any particular point in the coronary artery in living vivo. This method uses a thin catheter with the ultimately miniaturized ultrasound probe attached to its distal end and the probe rotates in the arterial lumen in order to receive an ultrasound radio frequency (RF) signal reflected from the vascular wall and the plaque.