Interventional Procedures Flashcards
What is the positive to interventional procedures?
Less invasive way to fix a problem
What are the 2 main reasons for vascular intervention?
Reduce or increase blood flow
What occurs to reduce blood flow?
Foreign substance, tissue or blood clot placed into the lumen of a selected vessel
What occurs to increase blood flow?
Percutaneous angioplasty via femoral or coronary arteries.
What are 6 ways to increase blood flow to arteries?
- Percutaeous transluminal angioplasty
- Primary stenting
- Directional coronary arthrectomy
- Percutaneous coronary rotational angioplasty
- Intravascular thrombolysis
- Infusion of vasodilators
What are different types of Vascular Interventional Angiopraghs?
- Balloon angioplasty
- Vascular stent
- Thrombolysis
- Embolization
- Retrieval
- Artherectomy
- Vena Cava Filter Placement
- Transjugular Interhepatic Potosystemic Shunt
What does TIPS stand for?
Transjugular Interhepatic Portosystemic Shunt
What occurs during a balloon angioplasty?
- Enlarge a stenosis of a vessel lumen
- Catheter used has 2 lumen one for guidewire and one for inflation/deflation
- 20-40 seconds for inflation
- Inflation with equal parts contrast and saline
What does the balloon pressing accomplish?
It presses the plaque into the vessel wall and is then withdrawn
What are some complications from angioplasties?
- Tear in artery wall
- Clot formation
- Perforation
- False aneurysm
- Arteriovenous Fistula
- Embolic showering
What is the purpose of a vascular stent?
- Enlarge the lumen of a vessel
- Provide support to hold vessel wall open
- Used as a primary procedure
What are some complications of a stent placement?
- Bleeding
- Infection
- Clot formation
- Premature placement or misplacement of stent
- Vessel Dissection
- Crimping of stent
What occurs within the vessel with the balloon and stent?
The balloon is inflated and it expands the stent. The balloon is then deflated and removed while the stent remains within the vessel.
What is Thrombolysis?
Destruction or lyse of a clot or thrombus.
What is used to destroy a clot or thrombus?
Urokinase with heparin or a bolus injection at the site.
What are some complications from Thrombolysis?
- Infection
- Bleeding
- Clot particles breaking off from vessel and blocking off a distal vessel
What is an Embolization?
Forming a thrombus od blocks flow of blood in a vessel
What substances are used in Embolization?
- Dehydrated alcohol
- Fibered coil
- Boiling Contrast
_ Glue - Gelfoam (squares that were in jar in class)
-Occlusion Balloons
What complications can occur from Embolizations?
- Infections
- Bleeding
- Ichemia
- Embolic agent at the intended site
- Rupture of the vessel
- Causing the clot to move
What occurs during retrieval?
Removal of foreign objects from blood vessels
What types of foreign objects are removed during Retrieval?
-Broken catheter or guidewire
What can happen if a foreign object is not removed during Retrieval?
- The object in venous flow will go to heart and lungs.
- If it passes through the heart it could cause an arrythmia which can cause death
- Arterial flow could cause other obstructions
What devices are used for retrieval?
- Balloon tip retrieval catheters
- Goose-neck snares
- Hook shaped catheters
- Baskets
What are complications from Retrieval?
- Bleeding
- Vessel Perforation
- Thrombosis
- Foreign body dislodges
What occurs during a Transjugular Interhepatic Portosystemic Shunt?
- The portal system is decompressed by shunting blood from the portal vein to the hepatic vein.
What is used for a Transjugular Interhepatic Portosystemic Shunt>
expandable metal stent
What are indications that the portal system is decompressed?
Variceal bleeding caused by hypertension, ascites, and primary cirrhosis
What is the technique used for Transjugular Interhpatic Portosystemic Shunts?
Right jugular vein is cannulated and a guidewire, catheter, and needle are manipulated into the hepatic vein. This goes through the liver parenychema into the portal vein where a stent is placed between the portal vein and the hepatic vein.
What are some complications from a Transjugular Interhepatic Portosystemic Shunt?
- Intraperitoneal hemorrhage
- Hepatic encephalopathy is a treatable side effect
- Amonia levels increase
- High mortality rate
What occurs during an Arthrectomy?
Plaque is cut away from the vessel wall usually in the extremities where narrowed area doesnt remain open after angioplasty. A shunt may be used to keep the vessel open
What are some complications from an Arthrectomy?
- Cutting through a vessel wall
- Clot formation
- Large hematomas at the puncture site
What does an arthrectomy catheter look like?
An egg beater/whisk
What are some reasons for Nonvascular Intervention?
- Percutaneous Methods (Modified Seldinger, Trocar Technique)
- Nephrostomy
- Percutaneous Biliary Drainage
- Percutaneous Needle Biopsy
- Gastrostomy Tube Placement
What are some Nonvascular Interventional Procedures?
- Needle Biopsy
- Puncture and drainage
- Percutaneoud calculi removal
- kidney stone removed
- non operative percutaneous calculi
- Extracorporeal shock wave lithotripsy
- Post op gallstones
