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Percutaneouse coronary intervention

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SHAPE Society

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Percutaneouse coronary intervention

  1. 1. PERCUTANEOUSE CORONARY INTERVENTION
  2. 2. HISTORICAL PERSPECTIVE  Balloon angioplasty was first performed by Andreas Gruentzig in 1977 with a fixed-wire balloon catheter.
  3. 3. design border spectrum of patients with more complex lesion are undergoing PCI.
  4. 4. Major advances The major advances in interventional cardiology continue as new technology is developed,tested,and brought to the clinical arena.These advances have led to the significant increase in procedural volume so that currently,the number of PCI exceeds the number of CABGs.
  5. 5. THE TECHNIQUE OF BALLOON DILATATION  A guide wire is passed across the stenosis  This is followed by deflated balloon  The balloon catheter is inflated within the lesion  The lumen is enlarged after balloon removal
  6. 6. BALLOON ANGIOPLASTY The improvement in luminal diameter of vessel is mainly due to cracking of the vessel wall that frequently extends through the plaque and the underlying media,allowing expansion of both the inner and outer diameter of the treated segment.
  7. 7. TWO MAJOR LIMITATIONS OF BALLOON ANGIOPLASTY : *Abrupt vessel closure 2-8% *Restenosis 30%-50%
  8. 8. THE NEW CORONARY DEVICES TO IMPROVE UPON PROCEDURAL OUTCOMES ACHIEVED WITH BALLOON ANGIOPLASTY:
  9. 9. Removing devices: Directional atherectomy Extraction atherectomy Debulking devices: Excimer laser angioplasty Scaffolding device: Stents Rotational atherectomy
  10. 10. STENTS(scaffolding devices) Coronary stents have fundamentally changed the practice of interventional cardiology by reducing early complication(abrupt vessel closure) and improving late clinical outcome(restenosis) and it is estimated that 50-80 percent of PCI procedures now involved the use of stent.

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