🔵 𝙈𝙚𝙘𝙝𝙖𝙣𝙞𝙨𝙢𝙨 𝙤𝙛 𝘼𝙣𝙜𝙞𝙤𝙥𝙡𝙖𝙨𝙩𝙮 𝙖𝙣𝙙 𝙎𝙩𝙚𝙣𝙩𝙞𝙣𝙜
#CCU_CORONARY

1️⃣. 𝘿𝙞𝙨𝙧𝙪𝙥𝙩𝙞𝙤𝙣 𝙤𝙛 𝙋𝙡𝙖𝙦𝙪𝙚 𝙖𝙣𝙙 𝙩𝙝𝙚 𝘼𝙧𝙩𝙚𝙧𝙞𝙖𝙡 𝙒𝙖𝙡𝙡
==============================
The inflated balloon exerts pressure against the plaque
and the arterial wall, causing fracturing and splitting.

• Concentric (round or circumferential) lesions
fracture and split at the thinnest and weakest points.

• Eccentric lesions split at the junction of plaque
and the normal arterial wall.

• Dissection or separation of the plaque from
vessel wall releases the restraining effect
caused by the lesion and results in a larger lumen.

👉This is the major mechanism of balloon angioplasty.

2️⃣. 𝙇𝙤𝙨𝙨 𝙤𝙛 𝙀𝙡𝙖𝙨𝙩𝙞𝙘 𝙍𝙚𝙘𝙤𝙞𝙡
===============
• Balloon dilatation causes stretching and thinning
of the medial musculature of the vessel wall.

• Stretching causes the vessel wall to temporarily
lose its elastic (recoil) properties.

• The degree of elastic recoil is affected by
the balloon-to-artery size ratio.

• Almost all vessels have some elastic recoil and,
over time, will recoil, which is a contributing
mechanism to restenosis.

• The major initial benefit of stenting is elimination
of elastic recoil, which maintains a large lumen over time.

3️⃣. 𝙍𝙚𝙙𝙞𝙨𝙩𝙧𝙞𝙗𝙪𝙩𝙞𝙤𝙣 & 𝘾𝙤𝙢𝙥𝙧𝙚𝙨𝙨𝙞𝙤𝙣 𝙤𝙛 𝙋𝙡𝙖𝙦𝙪𝙚
=============================
• During angioplasty, balloon pressure causes
denudation of vessel wall lining (endothelial)
cells and extrusion or pushing out of plaque components.

• There may be some extrusion longitudinally of
the softer lipid material, but this effect accounts
for a very small part of the overall effect.

💢 𝙋𝘾𝙄 𝙨𝙪𝙘𝙘𝙚𝙨𝙨 𝙙𝙚𝙛𝙞𝙣𝙚𝙙 𝙗𝙮
=================
Angiographic, Procedural, and Clinical criteria.

💜 𝘼𝙣𝙜𝙞𝙤𝙜𝙧𝙖𝙥𝙝𝙞𝙘 𝙎𝙪𝙘𝙘𝙚𝙨𝙨
================
• Final minimum stenosis diameter reduction to <10%.

❤️ 𝙋𝙧𝙤𝙘𝙚𝙙𝙪𝙧𝙖𝙡 𝙎𝙪𝙘𝙘𝙚𝙨𝙨
==============
• Angiographic success without in-hospital
major clinical complications
(e.g., death, m [MI], emergency CABG).

• MI is often defined as the development of
Q-waves in addition to elevation of troponins
three times the upper limits of normal value.

• Cardiac troponin T and I as measurements of
myocardial necrosis are more sensitive and
specific than CK-MB.

• Enzyme elevations in the absence of new
Q-waves is counted as MI, peri-procedural.

• There is no consensus on what level of troponin
alone is clinically important enough to change
major management following the interventional procedure.

💚 𝘾𝙡𝙞𝙣𝙞𝙘𝙖𝙡 𝙎𝙪𝙘𝙘𝙚𝙨𝙨
============
• A clinically successful PCI is an anatomic and
procedural success with relief of signs and/or
symptoms of myocardial ischemia after recovery
from the procedure.

• The long-term clinical success requires that
patient has continued relief of signs ,symptoms
of myocardial ischemia for more than 6 months.

• Restenosis is the principal cause of lack of
long-term clinical success when short-term
clinical success has been achieved.

❇️ 𝙃𝙤𝙬 𝘼𝙣𝙜𝙞𝙤𝙥𝙡𝙖𝙨𝙩𝙮 𝙖𝙣𝙙 𝙎𝙩𝙚𝙣𝙩𝙞𝙣𝙜 𝙒𝙤𝙧𝙠𝙨 ❓
=============================
(𝐀) The artery is filled with atherosclerotic material,
compromising the lumen.
A cross-section of artery is shown on RT side.

(𝘽) Guidewire is positioned past the stenoses
through the lumen.

(𝘾) Balloon catheter is advanced over guidewire.

(𝘿) The balloon is inflated.

(𝙀) The balloon is deflated and withdrawn.

(𝙁) The balloon catheter is exchanged for a stent
(on a balloon).

(𝙂) The stent is expanded.

(𝙃) The expanded stent remains in place after
the deflated balloon is withdrawn.

https://www.tg-me.com/cardiology