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ANGIOPLASTY / STENTING

What is an Angioplasty with Stenting?
Your healthcare provider has requested that you undergo an angioplasty with possible stent placement. Your symptoms or findings indicate that there is a blockage of blood flow within one of your vessels which can lead to complications. To open up this blockage, a balloon is inflated (angioplasty) within the blocked area and a stent (metal mesh) is often placed in the same area to keep the vessel open.

How Should I Prepare?
You should not eat or drink anything for six hours prior to your procedure. You may take your medications as directed. Speak to your doctor if you need to adjust your insulin dosing. Prior to your procedure, you should make sure all medications and allergies are updated. If you are on a blood thinner you may be requested to stop that medication for a period of time. If you are not admitted to the hospital, you will want to arrange for a ride home from a responsible adult.

How is the Procedure Performed?
The procedure will be performed by an interventional radiologist, who is a physician with specific training in image-guided procedures. The procedure will be performed under fluoroscopy (x-ray). Intravenous medications may be given to make you more comfortable and relaxed. This is called conscious sedation.

The skin is cleaned with a sterilizing solution and numbing medicine is injected into the skin. A catheter (small tube) is placed within the target vessel and advanced towards the blocked area. Once the catheter is in place, x-ray dye is injected and pictures of the concerned area are taken.

If the pictures show an area of blocked blood flow, then an angioplasty with stenting may be performed. As described earlier, an angioplasty involves inflating a balloon which dilates the blocked area. A stent (metal mesh) may be placed in the same area which will keep the vessel open and improve blood flow.

What Should I Expect After the Procedure?
Following the procedure, you may be monitored for any complications. To help prevent bleeding, you may be requested to lie in a specific position for a period of time.

ATHERECTOMY

What is an Atherectomy?
Your healthcare provider has requested that you undergo a procedure called an atherectomy. Your symptoms or findings indicate that you have plaque built up within your blood vessels creating a blockage or narrowing. While there are several methods and devices, one involves placing a catheter (small tube) into the blood vessel and using a small blade or rotating device to remove the plaque. This procedure isn't recommended for everyone and all cases are individualized.

How Should I Prepare?
You should not eat or drink anything for six hours prior to your procedure. You may take your medications as directed. Speak to your doctor if you need to adjust your insulin dosing. Prior to your procedure, you should make sure all medications and allergies are updated. If you are on a blood thinner you may be requested to stop that medication for a period of time. If you are not admitted to the hospital, you will want to arrange for a ride home from a responsible adult.

How is the Procedure Performed?
The procedure will be performed by an interventional radiologist, who is a physician with specific training in image-guided procedures. The procedure will be performed under fluoroscopy (x-ray). Intravenous medications may be given to make you more comfortable and relaxed. This is called conscious sedation.

The skin is cleaned with a sterilizing solution and numbing medicine is injected into the skin. A catheter (small tube) is placed within the target vessel and advanced towards the area of concern. Once the catheter is in place, x-ray dye is injected and pictures of the area are taken.

A specially designed catheter and/or device is used to remove the plaque that is built up within the blood vessel. The removal process can be repeated several times throughout the procedure until the blockage has improved, thus restoring blood flow. Once completed, the device used will be removed and pressure applied to the area to avoid bleeding.

What should I expect after the procedure?
Following the procedure, you will be monitored for a period of time for any complications. With successful atherectomy, most people can resume normal activities in a day or two.

THROMBOLYSIS

What is Thrombolysis?
Your healthcare provider has requested that you undergo thrombolysis, which is a procedure that involves using a medication (thrombolytic) to breakdown a blood clot. The medication is delivered through a catheter (small tube) positioned at the site of the clot. As the medication is delivered, the goal is to dissolve the clot to avoid further complications.

How Should I Prepare?
You should not eat or drink anything for six hours prior to your procedure. You may take your medications as directed. Speak to your doctor if you need to adjust your insulin dosing. Prior to your procedure, you should make sure all medications and allergies are updated. Patients undergoing this procedure will be admitted to the hospital and be monitored for any complications.

How is the Procedure Performed?
The procedure will be performed by an interventional radiologist, who is a physician with specific training in image-guided procedures. The procedure will be performed under fluoroscopy (x-ray). Intravenous medications may be given to make you more comfortable and relaxed. This is called conscious sedation.

The skin (usually groin area) will be cleaned with a sterilizing solution and numbing medicine injected into the skin. A catheter (small tube) will be advanced into the blood vessel towards the area where the blood clot is located. X-ray dye is then injected and pictures taken to visualize the area of concern.

If treating with a medication that dissolves blood clots, a small tube is left near the area of the clot and is attached to a machine that delivers a clot-dissolving medication. This medication is delivered into the clot over several hours or even a few days. Upon completion of treatment, the small tube will be removed and a sterile dressing applied to the area.

What Should I Expect After the procedure?
Following the procedure, you will be monitored for a period of time for any complications. Each day you will be evaluated to ensure that the clot is dissolving appropriately.

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John M. Neil, MD
Gavin P. Slethaug, MD
Mark J. Jorgensen, MD

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