Vascular Interventions

Question 1

What is baloon angioplasty and endovascular stenting?

Answer 1

Balloon angioplasty:

-inflation of an intravascular balloon catheter to dilate vessel

• risk of rupturing plaque -> thrombosis
• commonly performed with stenting to prevent rupture

Endovascular stenting:

-metallic stent on deflated balloon cathetier -> inflation expands stent, compressing plaque

Question 2

What are the types of endovascular stents?

What complications can occurs with them?

Answer 2

Metallic stent:

• can cause endothelial injury causing thrombosis
• antithrombotic drugs must be given during/following procedure
• significant rist of restenosis within 1 year

Drug-eluting stent:

-passively release antiproliferative drugs -> significant reduction of restenosis

Question 3

What are the main types of vascular replacement?

Answer 3

Synthetic grafts:

-only used for large vessel repairs (ie. aortic aneurysm)

Autologous grafts:

-used in small vessels repair (ie. coronary arteries; CABG)

Question 4

What are common sources of autologous grafts used in CABG?

What differences are there between them?

Answer 4

Saphenous vein:

• easier surgical procedure
• more likely to occlude long-term (50% patent at 10 yrs)

Left internal mammary artery:

• more complicated surgical procedure
• less likely to occlude long-term (90% patent at 10 yrs)