Invasive Angiography, PCI, Peripheral Angioplasty, CABG, Arterial Reconstruction

Question 1

Describe how you would do a coronary angiography

Answer 1

Catheter inserted into femoral artery => tip stops at LCA
Contrast injected into arteries => Xray imaging of coronaries

Needle => guidewire => sheath => tools

Question 2

Advantages

Disadvantages of angiography

Answer 2

MAJORITY OF STEMIs MANAGED WITH PCI THAN CABG
High spatial and temporal resolution
Assess
-arterial, microvascular physiology
-plaque characterisation
Can stent and balloon
Only small volumes of contrast needed

2D views only - must have multiple views

Question 3

What is fractional flow reserve

Answer 3

distal coronary pressure/proximal coronary pressure

Will be reduced in stenosis

Question 4

Angioplasty

Answer 4

Balloon inflation of stenosis => open stent

Drug coated stent prevent restenosis

Question 5

Describe how a CABG is done

Answer 5

Femoral vein
-graft to aorta to coronary past narrowing

Int mammary artery
-graft to coronary past narrowing

Question 6

Describe how a peripheral angioplasty is done

Answer 6

Similar to coronary angioplasty but done with peripheral leg vessels to manage claudication