Invasive Procedures

A dye study of the heart arteries that is performed under x-ray guidance. This allows your physician to directly visualize the arteries to identify a narrowing, or "blockages" that represent cholesterol buildup under the surface of the artery. The results of the catheterization will allow your doctor to plan the next step in your treatment. For example: angioplasty, coronary bypass graft surgery or medical therapy.

Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a nonsurgical procedure that improves blood flow to your heart. PCI requires cardiac catheterization, which is the insertion of a catheter tube and injection of contrast dye, usually iodine-based, into your coronary arteries. Doctors use PCI to open coronary arteries that are narrowed or blocked by the buildup of atherosclerotic plaque. PCI may be used to relieve symptoms of coronary heart disease or to reduce heart damage during or after a heart attack.

A cardiologist, or doctor who specializes in the heart, will perform PCI in a hospital cardiac catheterization laboratory. You will stay awake, but you will be given medicine to relax you. Before your procedure, you will receive medicines through an intravenous (IV) line in your arm to prevent blood clots. Your doctor will clean and numb an area on the wrist or groin where your doctor will make a small hole and insert the catheter into your blood vessel. Live x rays will help your doctor guide the catheter into your heart to inject special contrast dye that will highlight the blockage. To open a blocked artery, your doctor will insert another catheter over a guidewire and inflate a balloon at the tip of that catheter. Your doctor may put a small mesh tube called a stent in your artery to help keep the artery open.

A stent is a small mesh tube that's used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body.

A stent is placed in an artery as part of a procedure called percutaneous coronary intervention (PCI), also known as coronary angioplasty. PCI restores blood flow through narrow or blocked arteries. A stent helps support the inner wall of the artery in the months or years after PCI.

Doctors also may place stents in weak arteries to improve blood flow and help prevent the arteries from bursting.

Stents usually are made of metal mesh, but sometimes they're made of fabric. Fabric stents, also called stent grafts, are used in larger arteries.

Some stents are coated with medicine that is slowly and continuously released into the artery. These stents are called drug-eluting stents. The medicine helps prevent the artery from becoming blocked again.

Intravascular ultrasound (IVUS) is a medical imaging methodology using a specially designed catheter with a miniaturized ultrasound probe attached to the distal end of the catheter. The proximal end of the catheter is attached to computerized ultrasound equipment. It allows the application of ultrasound technology to see from inside blood vessels out through the surrounding blood column, visualizing the endothelium (inner wall) of blood vessels in living individuals.IVUS is of use to determine both plaque volume within the wall of the artery and/or the degree of stenosis of the artery lumen.

A procedure to remove plaque from arteries. An ultra-wire is threaded through a special catheter into the blocked artery. Several devices may be then be used. One is a high-speed rotating "burr" that grinds the plaque into very tiny pieces. Another is a small rotating cutter that "shaves off" pieces of the blockage. Still another is a laser catheter that vaporizes the plaque.

Peripheral angiograms are most commonly done to test the arteries which supply the blood to the head and neck or the abdomen and legs. Because arteries do not show up on ordinary x-rays, arteriograms utilize a contrast, which is injected into the arteries to make them visible on radiographs.

In this procedure, an ultrasound transducer is mounted on a long tube (probe) that is placed in the esophagus or food tube. Images are obtained by moving the probe within the esophagus and into the stomach. These images allow your doctor to evaluate your heart's muscle function, the severity of certain valve problems and to detect potential infection of the heart valves. Congenital heart problems, disease of the aorta and the presence of blood clots in your heart can also be detected. This test is done in a hospital and you are sedated.