Interventional Procedures

A specially designed guide wire with a filter is placed beyond the site of the narrowing/blockage in the carotid artery. Once the filter is in place, a small balloon catheter is guided to the area of the blockage. When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened (dilated) to increase blood flow. The balloon is removed and the stent is permanently placed inside the artery to widen the opening and support the artery wall. This procedure is done in the hospital.

Percutaneous transluminal coronary angioplasty (PTCA), or balloon angioplasty, is a procedure used to open narrowed coronary arteries. A thin catheter is inserted through the groin or the arm, the balloon is wired through the catheter to the area of narrowing, it is inflated and then removed. Balloon angioplasty is usually used in conjunction with stent placement.

A stent is small expandable tube that is permanently placed in narrowed arteries. The physician will implant the stent 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, compressing the plaque and allowing blood to flow through the coronary arteries. There are two types of stents: Bare metal stent and drug-eluting stent. A drug-eluting stent is coated with medicine that helps keep the artery open after the procedure. This is done in-hospital under sedation.

Also known as a coronary angiography or heart catheterization, a thin catheter is inserted through the arteries in the groin or arm. Live X-rays are then used to view the coronary arteries, heart valves and chambers of the heart. This is able to provide the physician with detailed information about the structure and function of the heart and its arteries. It is performed in-hospital under sedation.

Abdominal Aortic Aneurysm (AAA) is a weakness in the wall of the abdominal aorta, which has resulted in a bulge or expansion. AAA can expand the aorta beyond its safety margins. At this point it is possible that the aneurysm can burst or rupture, which can cause internal bleeding and lead to shock and even death. Repairing the AAA is usually recommended when the size becomes significant and there is a risk for rupture. Endovascular repair is a fairly new procedure and much less invasive than the traditional open repair. For more information, please visit http://www.nlm.nih.gov/medlineplus/ency/article/007391.htm

A patent foramen ovale (PFO) is a hole in the heart that should have closed after birth. This is located in between the right and left top chambers of the heart, called the atria. Approximately 25% of the population has a PFO.
This type of defect generally works like a flap valve, only opening during certain conditions when there is more pressure inside the chest. This increased pressure occurs when people strain while having a bowel movement, cough, or sneeze. If the pressure is great enough, blood may travel from the right atrium to the left atrium. If there is a clot or particles in the blood traveling in the right side of the heart, it can cross the PFO, enter the left atrium and travel out of the heart and to the brain causing a stroke or a coronary artery causing a heart attack. Physicians are now able to close a PFO through a catheter, using a PFO closure device, which is a permanent implant designed to close the hole in the heart wall. This device will stop abnormal blood flow between the right and left atria. This procedure is done under sedation and in the hospital. For more information, please visit http://my.clevelandclinic.org/heart/disorders/congenital/pfo.aspx

Percutaneous transluminal coronary angioplasty (PTCA), or balloon angioplasty, is a procedure used to open narrowed arteries in the legs. A thin catheter is inserted through the groin or the arm, the balloon is wired through the catheter to the area of narrowing, it is inflated and then removed. This is usually done in conjunction with peripheral stenting. It is performed in the hospital under sedation.
The physician will make 1-2 cuts (incisions) in the groin area. Small flexible tubes (catheters) are inserted into arteries in the groin area. The physician then puts dye into the arteries, which will make the aorta visible on X-ray. Catheters are used to move a man-made tube (stent graft) through the arteries until it reaches the aorta. The graft is then expanded inside of the aneurysm and attaches the graft to the blood vessel. When the graft is in place, the physician will take out the catheters and/or wires and use stitches to close the incision(s) in the groin area. After the procedure has completed, blood passes through the graft in the aorta without pushing on the aneurysm.

Transcatheter Aortic Valve Replacement is a new procedure to treat severe and symptomatic aortic stenosis in patients who are not good candidates, or high risk candidates, for traditional open chest surgery. This procedure is done through a catheter where a balloon expandable aortic valve is placed at the native valve site.