Here are brief descriptions of some of the procedures performed by the interventional cardiologists at Munroe Heart:
A stent is a wire metal mesh tube used to prop open an artery during angioplasty. The stent acts as a scaffold and remains in place permanently to help keep the artery open.
Drug Eluting Stents
Drug-eluting stents, sometimes referred to as a "coated" or "medicated" stent, are a normal metal stent that has been coated with drugs that potentially reduce the chance the arteries will become blocked again.
Carotid artery stenting is a procedure in which the physician inserts a stent into the carotid artery. The stent expands inside the carotid artery to increase blood flow in areas blocked by plaque.
Renal stenting is a procedure in which the physician inserts a stent into the renal artery. The stent expands inside the renal artery to increase blood flow in areas that are blocked by plaque.
Peripheral stenting is a procedure in which the physician inserts a stent into a blood vessel that flows away from the central core of the body (i.e. legs, kidneys, etc). The stent expands inside the artery to increase blood flow in areas that are blocked by plaque.
Fox Hollow is a plaque excision procedure that is a minimally invasive and is performed through a tiny puncture site in the leg or arm. The SilverHawk® technology uses a tiny rotating blade to shave away plaque from inside the artery. As it is excised, the plaque collects in the tip of the device and then is removed from the patient once enough plaque is removed to restore normal blood flows to the legs again. Plaque excision has helped alleviate severe leg pain for thousands of patients and in many cases has successfully saved the legs of patients who were scheduled for limb amputation after other peripheral interventions failed.
CryoPlasty is a new type of therapy for peripheral vascular disease. The technique is very similar to angioplasty procedures used in heart vessels, except stents are not used to keep the blood vessel open. Clogged or narrowed arteries can be opened using this new type of vascular therapy that cools and dilates the vessel at the same time. In CryoPlasty, a balloon is filled with liquid nitrous oxide, which evaporates into a gas upon entering the balloon, causing it to dilate and cool to -100C (140F). The plaque clogging the artery then cracks when it freezes, allowing for a more uniform dilation of the blood vessel.
The coronary rotoblader procedure is similar to a coronary angioplasty, but it adds an additional step. The physician uses a catheter with a precision, rotating blade at its tip to shave away any excess plaque that as accumulated in the artery. In most cases there is still plaque after this first step of the procedure is performed so the doctor then inserts a balloon catheter to compress the remaining plaque against the artery wall.
Inferior Vena Cava Filter
Vena cava filters are metallic, umbrella-shaped devices that catch blood clots to prevent them from traveling to the lungs and causing a pulmonary embolism. Vena cava filters have small nets that help to prevent emboli from traveling through the heart and into the lungs. Most commonly, vena cava filters are inserted into the inferior vena cava, a large vein that carries blood from the lower extremities.
Arteriovenous Fistula Examinations
An arteriovenous fistula (AV fistula) is a procedure in which the physician connects a vein to an artery. This is usually done in a patient's forearm to allow access to the vascular system for hemodialysis. The surgical creation of an AV fistula provides a long-lasting site through which blood can be removed and returned during hemodialysis. In some cases the AV Fistula can develop a clot, which does not allow for access to the vascular system. When this happens the interventional cardiologist will use a catheter and inject dye into the site to determine the problem and act accordingly by either breaking up the clot or referring the patient to a surgeon to have another AV fistula created.
Atrial Septal Defect Transcatheter Closure (ASD Closure)
Atrial Septal Defect is a common heart defect that babies are born with. With an ASD, there is a hole in the wall between the two upper (atrial) chambers of the heart. The ASD causes some of the blood from the left atrium to flow back into the right atrium, which causes the heart and lungs to work harder. During the ASD closure procedure, catheters are placed into a large blood vessel, usually the groin, and guided through the vessel into the heart. The ASD closure device is guided through the catheter to the atrial septal defect. After the catheter tip is moved into place, the device is pushed out of the catheter, across the atrial septal defect, and secured in place. After the device is secured, heart tissue will begin to grow over it in about three months.
Patent Foramen Ovale (PFO)
A patent foramen ovale (PFO) is a defect in the wall between the two upper chambers of the heart. The defect is caused by an incomplete closure of the atrial septum that results in the creation of a flap or a valve-like opening in the atrial septal wall. The flap can open when pressure inside the chest increases, which can cause blood to travel from the right atrium to the left atrium. During the PFO closure procedure, catheters are placed into a large blood vessel, usually the groin, and guided through the vessel into the heart. The PFO closure device is moved through the catheter to the location of the patent foramen ovale in the heart. The PFO closure device then expands from the catheter and covers the hole in the heart. The PFO closure device remains in the heart permanently to stop the abnormal flow of blood between the two atria chambers of the heart.