Cardiac Treatment Options

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Your treatment procedure will be determined after your initial diagnostic testing is reviewed. The treatment options available at CRMC include:

• Arrythmias
• Catheter-based interventions

If a catheter-based intervention is possible, it can be performed in the cath lab while you are there. The catheter-based interventions include:

• Percutaneous Transluminal Coronary Angioplasty (PTCA)
• Stent Placement
• Rotational Atherectomy

Other interventions, such as an Abdominal Aortic Aneurysm Stent Graft may be performed in the operating room.

Percutaneous Transluminal Coronary Angioplasty (PTCA)

Percutaneous Transluminal Coronary Angioplasty, also known as angioplasty or PTCA, is a method of widening an area of an artery narrowed by fatty deposits without surgery. The procedure is similar to a cardiac catheterization. A catheter with a small, inflatable balloon on the end is guided through the artery until the balloon is positioned in the narrowed section of the artery. The balloon is inflated for up to thirty seconds, pressing the fatty deposits against the wall of the artery. The balloon may be inflated and deflated several times during the angioplasty. It is common to have some chest discomfort when the balloon is inflated because the blood flow through the artery is temporarily stopped; however, the discomfort should subside when the balloon is deflated. As a result of the angioplasty, the diameter of the blood vessel is increased, improving blood flow in the artery.

Stent Placement

A coronary stent is a small, latticed, high grade stainless steel tube which is used to hold the coronary artery open and minimize the chance of abrupt closure after angioplasty. It is placed in the coronary artery using the same procedure as the angioplasty. The stent is typically mounted on a balloon angioplasty catheter. It is positioned at the narrowed area of the artery. When the balloon is inflated, the stent expands and is pressed against the vessel wall. The balloon is deflated and withdrawn, leaving the stent permanently in place.

After a stent is placed, you will be prescribed an antiplatelet medication. This is used to minimize the risk of clot formation in the stent while tissue grows around the stent to incorporate in into the blood vessel wall. Within one month's time, the body no longer "sees" the stent, and the medication is no longer needed. You should continue to take Aspirin, if it has been prescribed, along with other antiplatelet medications.

Rotational Atherectomy

Rotational Atherectomy widens narrowed arteries using a high-speed rotational device to "sand" away plaque. This technique is used in particular situations, such as with plaque with large amounts of calcium or to widen blockages within a stent.

Abdominal Aortic Aneurysm Stent Graft

A new, minimally invasive treatment is available at Capital Region for Abdominal Aortic Aneurysms (AAA) – a bulge in the wall of the body’s largest artery. The AneuRx stent graft is a modular system that expands to fit within the diameter of the aorta, providing a new path for blood flow and reducing the pressure on the aneurysm, thereby preventing rupture. Implanted through a delivery catheter into the femoral artery in the upper thigh, the system is guided through the aorta by a process called fluoroscopy to the location of the aneurysm.

The procedure is just as effective as open abdominal surgery but reduces the risk of major complications by half. Other benefits for patients include a faster recovery time and reduced hospital stay.