PERCUTANEOUSE CORONARY INTERVENTION

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PERCUTANEOUSE CORONARY INTERVENTION
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HISTORICAL PERSPECTIVE

• Balloon angioplasty was first performed by
  Andreas Gruentzig in 1977 with a fixed-wire
  balloon catheter.

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By rapidly evolving operators experiences and
equipment design border spectrum of patients with
more complex lesion are undergoing PCI.





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Major advances

• The major advances in interventional cardiology
  continue as new technology is developed,tested,and
  brought to the clinical arena.These advances
  have led to the significant increase in
  procedural volume so that currently,the number of
  PCI exceeds the number of CABGs.

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THE TECHNIQUE OF BALLOON DILATATION

• A guide wire is passed across the stenosis
• This is followed by deflated balloon
• The balloon catheter is inflated within the
  lesion
• The lumen is enlarged after balloon removal

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BALLOON ANGIOPLASTY

• The improvement in luminal diameter of vessel is
  mainly due to cracking of the vessel wall that
  frequently extends through the plaque and the
  underlying media,allowing expansion of both the
  inner and outer diameter of the treated segment.

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TWO MAJOR LIMITATIONS OF BALLOON ANGIOPLASTY
Abrupt vessel closure 2-8 Restenosis
30-50


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THE NEW CORONARY DEVICES TO IMPROVE UPON
PROCEDURAL OUTCOMES ACHIEVED WITH BALLOON
ANGIOPLASTY
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Removing devices Directional
atherectomy


Rotational atherectomy

Extraction atherectomy
Debulking devices Excimer laser
angioplasty
Scaffolding device Stents
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STENTS(scaffolding devices)

• Coronary stents have fundamentally changed the
  practice of interventional cardiology by reducing
  early complication(abrupt vessel closure) and
  improving late clinical outcome(restenosis) and
  it is estimated that 50-80 percent of PCI
  procedures now involved the use of stent.

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