percutaneous transluminal coronary angioplasty


angioplasty

 [an´je-o-plas″te] an angiographic procedure for elimination of areas of narrowing in blood vessels.balloon angioplasty angioplasty in which a catheter" >balloon catheter is inflated inside an artery, stretching the intima and leaving a ragged interior surface after deflation, which triggers a healing response and breaking up of plaque.percutaneous transluminal angioplasty a type of balloon angioplasty in which the catheter is inserted through the skin and through the lumen of the vessel to the site of the narrowing.percutaneous transluminal coronary angioplasty (PTCA) percutaneous transluminal angioplasty to enlarge the lumen of a sclerotic coronary artery (see accompanying illustration). This provides an alternative to cardiac bypass" >bypass surgery for selected patients with ischemic heart disease. See also heart. Percutaneous transluminal coronary angioplasty (PTCA). A, Balloon-tipped catheter positioned in blocked artery. B, Balloon is centered. C, Balloon expands to (D) compress blockage. E, Artery diameter opened. From Polaski and Tatro, 1996.

per·cu·ta·ne·ous trans·lu·mi·nal cor·o·nar·y an·gi·o·plas·ty (PTCA),

an operation for enlarging the narrowed lumen of a coronary artery by inflating and withdrawing through the stenotic region a balloon on the tip of an angiographic catheter.

PTCA is a minimally invasive surgical procedure for the treatment of coronary atherosclerosis. A balloon-tipped catheter is inserted percutaneously into the arterial circulation, advanced to the aortic root, and directed with a flexible guide wire to the site of coronary stenosis. Having been positioned within the narrowed arterial segment, the balloon is inflated so as to stretch the lumen, fracture the obstructing plaque, or both. Balloon angioplasty is considered successful when there is more than a 20% increase in the caliber of the stenotic artery and restoration of at least 50% of normal patency, without acute complications. The procedure has approximately a 90% immediate success rate. It offers advantages in symptom improvement and exercise tolerance when compared with medical therapy, particularly in the short term, and is less hazardous and has a shorter recovery period than coronary artery bypass grafting (CABG). Operative mortality is about 2%. There is a 1-3% risk of nonfatal acute myocardial infarction during the procedure and a 1-3% risk that emergency CABG will be required. Hence, the procedure is contraindicated unless a coronary bypass surgical team is immediately available. It is also contraindicated in people without demonstrated significant vascular obstruction, as well as in those with severe multivessel disease or more than 50% stenosis of the left main coronary artery. Angioplasty performed within 2 hours after onset of pain in acute myocardial infarction yields a lower mortality rate and lower rates of nonfatal reinfarction and hemorrhagic stroke than thrombolytic therapy. Despite the advantages of PTCA, 30-50% of patients require repeat balloon angioplasty or CABG for restenosis within 6 months. Insertion of a stainless steel stent at the time of balloon angioplasty to maintain arterial patency has improved initial success and reduced the 6-month restenosis rate. Paclitaxel- and sirolimus-eluting stents further reduce the risk of restenosis.

percutaneous transluminal coronary angioplasty

(trăns-lo͞o′mə-nəl, trănz-)n. A procedure for enlarging a narrowed arterial lumen by peripheral introduction of a balloon-tip catheter followed by dilation of the lumen as the inflated catheter tip is withdrawn.

percutaneous transluminal coronary angioplasty

A term which is now being retired in favour of percutaneous coronary intervention, a term which is broader in scope and includes use of balloons, stents, and atherectomy as means of increasing blood flow through native coronary arteries.

percutaneous transluminal coronary angioplasty

PCTA Interventional cardiology A procedure in which an angioplasty balloon is inserted percutaneously into the arteries advanced to a stenosis, and inflated, reopening the lumen Indications Single and multivessel CAD, stable angina on exertion, unstable angina, acute MI–'primary' PCTA, stenosed renal arteries, arteries with fibromuscular hyperplasia, post-thrombolytic therapy Success rate 90%; re-stenosis in 30%; success is lower with stenoses that are chronic, long, eccentric, angulated, calcified, at branching, or with intraluminal thrombi, unstable angina, ↑ age, ♀. See Balloon angioplasty, Coronary artery bypass surgery, Excimer laser therapy. Cf Balloon valvoplasty.

per·cu·ta·ne·ous trans·lu·mi·nal cor·o·nar·y an·gi·o·plas·ty

(PTCA) (pĕr'kyū-tānĕ-ŭs trans-lūmi-năl kōrŏ-nar-ē anjē-ō-plastē) Surgical operation for enlarging the narrowed lumen of a coronary artery by inflating and withdrawing through the stenotic region a balloon on the tip of an angiographic catheter.

per·cu·ta·ne·ous trans·lu·mi·nal cor·o·nar·y an·gi·o·plas·ty

(PTCA) (pĕr'kyū-tānĕ-ŭs trans-lūmi-năl kōrŏ-nar-ē anjē-ō-plastē) Surgical operation for enlarging the narrowed lumen of a coronary artery by inflating and withdrawing through the stenotic region a balloon on the tip of an angiographic catheter.