Making emergency artery repair safer

December 06, 2007

Sacramento, Calif. - December 6, 2007 - Catheters outfitted with balloons, lasers, and miniature drills have made the treatment of blocked arteries virtually routine. These devices are used to clear plaque from many vessels including coronary, femoral, renal, and carotid arteries. Until recently, a misstep in the delicate procedure usually required risky emergency surgery. Now physicians are using the same technology used to open clogged arteries to repair ruptures and perforations with less risk. In an article in the Journal of Interventional Cardiology, researchers from the University of California, Davis Medical Center review state-of-the-art treatment for vessel punctures.

"Rupture or perforation of a blood vessel during angioplasty can result in life-threatening bleeding," said lead author John Laird, M.D. "This review provides doctors with a summary of equipment and techniques that will enhance their ability to treat such complications."

An estimated 0.1% of patients undergoing balloon angioplasty, which uses an inflatable balloon to widen arteries, suffer a perforation during the procedure. Patients treated with a rotablator drill have a 1.3% risk of perforation, while those treated with the excimer laser face a 1.9% risk. Balloon, drill, and laser are all attached to a catheter inserted through a small incision in the arm or groin and snaked through an artery to the blockage.

Following a puncture, Laird and his colleagues first recommend inflating a balloon at the site to stem the bleeding. Then they suggest inserting embolization coils or a flexible tube called a stent graft to repair the vessel. Treatment also involves drug therapy to promote clotting.

In their review, the authors describe several types of balloons, stents, and coils. They urge physicians who perform angioplasty to become familiar with the supplies they stock in order to be prepared for an emergency.
-end-
This study is published in the Journal of Interventional Cardiology. Media wishing to receive a PDF of this article may contact medicalnews@bos.blackwellpublishing.net.

John R. Laird, MD, is affiliated with the Division of Cardiovascular Medicine at the University of California, Davis Medical Center and can be reached for questions at john.laird@ucdmc.ucdavis.edu.

The Journal of Interventional Cardiology (JIC) is widely regarded as a must-read for the interventional cardiologist determined to stay current in diagnosing, investigating, and managing patients with cardiovascular disease. JIC publishes the most reliable and authoritative papers from the wealth of information that becomes available as new procedures and techniques develop.

Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley's Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit www.blackwellpublishing.com or http://interscience.wiley.com .

Blackwell Publishing Ltd.

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