Carotid artery stenting is a procedure in which your cardiologist inserts a slender, metal-mesh tube, called a stent, which expands inside your carotid artery to increase blood flow in areas blocked by plaque.
In atherosclerosis or hardening of the arteries, plaque builds up in the walls of your arteries as you age. Cholesterol, calcium, and fibrous tissue make up the plaque. As more plaque accumulates, your arteries can narrow and stiffen. Eventually, enough plaque may build up to reduce blood flow through your arteries, or cause blood clots or pieces of plaque to break free and to block the arteries in the brain beyond the plaque.
Before and after stent
Coronary Balloon Angioplasty
Percutaneous transluminal coronary angioplasty (PTCA), or balloon angioplasty, is a procedure used to open narrowed coronary arteries. It is performed with a local anesthesia while the patient is awake. Patients whose angina has not been relieved by medications are generally the best candidates for PTCA. There are several other commonly used treatments for opening blocked arteries such as the Rotoblator procedure (tiny rotating blades) or Atherectomies (cutters) to cut away plaque buildup on the artery walls, or Stents (a little metal “scaffold”) that widens obstructed arteries.
The Stent is a stainless steel device (scaffold) which compresses the plaque, much like in the coronary balloon angioplasty procedure. It is implanted by guiding a thin, balloon-tipped catheter through the artery to the blockage. The collapsed stent is part of the catheter tip, and when the balloon is inflated the stent expands into place allowing the flow of blood once again through the coronary arteries. After a couple of weeks tissue forms around the stent and it becomes a permanent support for the artery.
A diagnostic cardiac Catheterization, also called coronary angiography or heart catheterization, is a procedure that provides detailed information about the function of the heart and its arteries. By combining that information from blood tests and other diagnostic tests with a cardiac catheterization procedure, your doctor can accurately diagnose a heart condition and the most effective treatment plan.
Abdominal Aortic Aneurysm(AAA) is a weak area of the abdominal aorta that expands or bulges. The pressure from blood flowing through your abdominal aorta can cause a weakened part of the aorta to bulge, much like a balloon. A normal aorta is about 1 inch (or about 2 centimeters) in diameter. However, an AAA can stretch the aorta beyond its safety margin as it expands. Aneurysms are a health risk because they can burst or rupture. A ruptured aneurysm can cause severe internal bleeding, which can lead to shock or even death.
Endovascular means that the treatment is performed inside your artery using long, thin tubes called catheters that are threaded through your blood vessels. This procedure is less invasive, meaning that your cardiologist will need to make small incisions in your groin area through which to thread the catheters. During the procedure, your cardiologist will use live x-ray pictures viewed on a video screen to guide a fabric and metal tube, called an endovascular stent graft (or endograft), to the site of the aneurysm., the endovascular stent graft also strengthens the aorta.
The illustration to the left shows the placement of an endovascular stent graft in an aortic aneurysm. In figure A, a catheter is inserted into an artery in the groin (upper thigh). It is then threaded up to the abdominal aorta, and the stent graft is released from the catheter. In figure B, the stent graft allows blood to flow through the aneurysm.
Approximately 6 million adults in the United States have been diagnosed with Atrial Fibrillation. The condition accounts for more than 20 percent of stroke-related deaths. Heart & Vascular Center of Arizona is one of a select group of physicians that can implant this device now in patients who meet appropriate criteria.
The left Atrial Appendage is the primary source of blood clots leading to stroke in patients with atrial fibrillation (AF). The most common heart rhythm disorder, AF causes the upper chambers of the heart to beat fast and erratically. If uncontrolled, the condition can have serious consequences, including stroke and early death. Individuals who do take blood thinners and other anticoagulants must rigorously manage the level of the drugs in their blood.
The new FDA-approved LARIAT® Suture Delivery Device, a nonsurgical lasso procedure could provide long-term protection against stroke in patients with AF who are unable to tolerate blood thinners. The LARIAT procedure eliminates the risks associated with the need to take long-term medications.
Patent Foreman Ovale Closure
A patent foramen ovale (PFO) is a hole in the heart that didn’t close the way it should after birth. The condition is relatively common. During fetal development, a small flap-like opening — the foramen ovale (foh-RAY-mun oh-VAY-lee) — is usually present between the right and left upper chambers of the heart. It normally closes within the first or second year of life. When the foramen ovale doesn’t close, it’s called a patent foramen ovale. With each heart beat or when a person with this defect creates pressure inside his or her chest – such as when coughing, sneezing, or straining during a bowel movement – the flap can open, and blood can flow in either direction directly between the right and left atrium. When blood moves directly from the right atrium to the left atrium, this blood bypasses the filtering system of the lungs (the lungs actually do dissolve tiny blood clots). If debris is present in the blood, such as small blood clots, it now passes through the left atrium and can lodge in the brain, causing a stroke, or another organ, such as the heart, eyes, or kidneys.
Catheter-based procedures are commonly used to diagnose and treat heart-related problems. For example, catheter-based procedures are used to diagnose and treat clogged arteries and heart attacks. A catheter can also be used to guide the placement of a patent foramen ovale closure device – which becomes a permanent implant – that will close the hole (prevent the flap from opening) in the heart wall. Once in the correct location, the PFO closure device is allowed to expand its shape to straddle each side of the hole. The device will remain in the heart permanently to stop the abnormal flow of blood between the two atria chambers of the heart. The catheter is then removed and the procedure is complete. This procedure takes about 1-2 hours to perform in the hospital Cardiac Catheterization Lab.
Peripheral angioplasty is performed much like that of PCTA or percutaneous transluminal coronary angioplasty, but to open blocked arteries or remove blood clots in the patient’s legs.
Rotoblater and Atherectomies
The rotoblator is a procedure used to clear blocked arteries. Your doctor guides a thin catheter through the artery to the blocked area. The catheter contains a small, specially designed, rotating blade which chips off hard plaque buildup on the artery walls. The chips of plaque are then small enough to be absorbed and expelled into the blood stream. The atherectomy procedure is similar however it contains a cutter which shaves the plaque away from the artery wall. The plaque is then removed through the catheter. Both procedures are used to effectively clear blocked arteries.
Transcatheter Aortic Valve Replacement (TAVR) Program
Transcatheter Aortic Valve Replacement (TAVR) is a procedure for select patients with severe symptomatic aortic stenosis (narrowing of the aortic valve opening) who are not candidates for traditional open chest surgery or are high-risk operable candidates.
While up to 1.5 million people in the U.S. suffer from aortic stenosis (AS), approximately 500,000 within this group of patients suffer from severe AS.
The TAVR procedure enables the placement of a balloon expandable aortic heart valve into the body via the catheter-based transfemoral delivery system. The TAVR procedure is designed to provide an alternative treatment to patients in whom the traditional open-heart surgery can not be performed.
The Edwards SAPIEN Valve is the first and only transcatheter aortic valve approved for use in the U.S., and Hartford Hospital is one of a few select hospitals that are now performing the procedure on qualified patients.
Trivascular Ovation Prime Endograft
The Heart & Vascular Center of Arizona is now able to treat your Aortic Aneurysm Patients with the new Trivascular Ovation Prime Endograft.
Advantages of the trivascular ovation prime endograft:
- Unparalleled Clinical Data
- Novel Technology
- Percutaneous Procedure / No incisions necessary
- Minimally Invasive
- Next Day Discharge
- Early Ambulation (2-4 hours)
- Conscious Sedation
- Custom Seal
Abdominal Aortic Aneurysm Facts:
- AAA affects as many as eight percent of people over the age of 65.
- 200,000 people are diagnosed with an AAA each year.
- Accounts for approximately 15,000 deaths annually.
- Third leading cause of death in men over 60.
There are options…
If you would like more information, please contact Adam Brodsky MD, Joshua Waggoner MD
1331 N. 7th St. #375, Phoenix, AZ 85006 | (602) 307-0070