Leaders in the Development of Interventional Cardiology
In the early 90's when LRMC's interventional cardiologists performed the first cardiac catheterizations in the region, our hospital took its place as a leader in cardiovascular healthcare.
Soon after, they began taking advantage of this relatively easy access to the inner workings of the heart to not only locate, but treat blockages or narrowing within the coronary arteries, with procedures including angioplasty, a non-surgical procedure which "opens up" obstructed arteries, stents, which keep arteries open, and drug-eluting stents which prevent re-obstruction.
LRMC specialists helped develop many of the procedures to treat coronary artery disease that today are considered cardiology's gold standard and continue to develop new interventional techniques to improve patient outcomes in even the most complex and difficult situations.
In fact, most patients with severe coronary artery disease can be treated at LRMC without coronary artery bypass surgery.
Interventional Cardiology Procedures
Interventional cardiology procedures are non-surgical treatments performed to restore or improve blood flow to the heart which has been restricted by narrowed coronary arteries. Interventional procedures can be performed during a diagnostic cardiac catheterization (cath) if a blockage is identified or may be scheduled as a follow-up to a cardiac cath during which the interventional cardiologist diagnosed the presence of coronary artery disease.
Like diagnostic cardiac caths, interventional procedures are performed by threading a long, slender, flexible catheter through arteries in the groin, wrist or other location to the exact spot in the heart where the narrowing or blockage has occurred. Fluoroscopy is used by the interventional cardiologist performing the procedure to guide the catheter to the location of the blockage. Once the catheter is in place, interventional procedures such as balloon angioplasty, stent placement, rotablation or others can be performed.
The positive results of these procedures at LRMC have resulted in improved heart health for thousands of patients throughout the region.
Interventional Cardiology Procedures include:
Also known as percutaneous coronary intervention (PCI) or percutaneous transluminal coronary angioplasty (PTCA), balloon angioplasties are minimally-invasive procedures performed by inserting a small balloon at the tip of a flexible catheter close to the narrowed area of the coronary artery. The balloon is then inflated, compressing the blockage (usually fatty plaque) against the artery wall, thereby increasing the diameter of the artery and improving blood flow. At times, re-closure can occur. To offset this possibility, a stent may be inserted also using a catheter.
Balloon angioplasty with stenting
In many cases, balloon angioplasties will be accompanied by a stenting procedure which will help to keep the artery open. A stent is a tiny, coiled wire or mesh tube which holds the walls of the artery in place, improving blood flow. Stents can also be inserted during a heart attack to quickly open blockages and reduce damage to the heart muscle.
Drug-eluting stents may be used to reduce the risk that the artery will restenose (or close). These stents have a thin coating of a medication which reduces the risk of restenosis.
Rotablation (Percutaneous Transluminal Rotational Atherectomy or PTRA) utilizes a special catheter, with a diamond-coated tip which spins rapidly, and is used to actually remove plaques from the walls of the artery, to treat blockage in the coronary arteries and improve blood flow. The catheter collects the plaque in a chamber in the tip, which allows removal of the plaque as the device is removed from the artery. Laser catheters are sometimes used to vaporize the plaque.
The cutting balloon catheter has a balloon tip with small blades. When the balloon is inflated, the blades are activated. The small blades score the plaque, then, the balloon compresses the fatty matter into the arterial wall. This type of balloon may be used to treat the build up of plaque within a previously placed stent (restenosis) or other types of blockages.
These specialized devices help to filter and catch tiny pieces of plaque which can break off and travel through the blood stream during interventional procedures.