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Nov30
ENDOVASCULAR TREATMENT PERIPHERAL ARTERIAL OCCLUSIVE DISEASES: CURENT STATUS
Interventional radiology of peripheral vascular disease comprises therapeutic measures with imaging system. It includes recanalisation of arteries in symptomatic patients.
IMAGING – To identify site and degree of vascular problem
(i)Color Doppler.
(ii)MR Angiography and CT angiography
(iii)Catheter Angiography

The arterial occlusive disease can be 1. Chronic or 2. Acute
I.CHRONIC ARTERIAL OCCLUSIVE DISEASES

1.Angioplasty and Stenting- Balloon angioplasty/stent: opening of narrow or blocked blood vessels using a balloon; may include placement of metallic stents as well (both self-expanding and balloon expandable).

2.Endovascular stent grafts- In certain situations like long arterial occlusions. Lesions not suitable for angioplasty and stenting endovascular stent graft/ covered stents are used.

II ACUTE ARTERIAL OCCLUSIVE DISEASES

1. Arterial embolism in arteries of extremities

Angiographic signs of embolic occlusion are abrupt occlusion, convexly bent filling defect, intact vascular system proximal and distal of embolic occlusion, multiple occlusion and occlusion at bifurcation.
2.Acute thrombosis in extremity arteries

Angiographic criteria of thrombotic occlusion
The occlusion has blurred, cloudy demarcation, atherosclerotic changes and arterial stenosis are present.
treatment:
(i)Pharmacological thrombolysis –It is used within two weeks of thrombotic occlusion.Intra arterial urokinase./r-TPA is used to treat these lesions.

(ii)Mechanical Thrombectomy
These percutaneous mechanical thrombectomy procedures are efficient at relieving obstruction in short period of time with little or no thrombolytics and hence increase efficiency while diminishing cost of procedure. There are rotational thrombectomy devices which treat occlusions up to 6 months


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