Hello welcome everybody, this is Dr Bolad, board certified physician in cardiology,
interventional cardiology and internal medicine. I am here to help you with all the information
you need for your heart health and informing you about all the latest treatments in cardiology. If
you are new to this channel and would like to take great care of your heart then definitely consider
hitting the subscribe button below and switch on the notification bell so you don't miss any new
videos. Today I will be talking to you about heart stents used to open blocked coronary arteries in
order to maintain blood flow to the heart muscle. The procedure that we perform to deliver heart
stents to the coronary arteries is known as percutaneous coronary intervention abbreviated
as PCI. This is an invasive procedure performed to improve blood flow to the heart muscle.
A patient with a known blockage of the coronary artery or arteries is brought to the cardiac
catheterization laboratory for the procedure. We access the circulation commonly either
through the femoral artery in the groin or the radial artery in the wrist. The illustration
shows the femoral artery which is a large artery delivering blood to the leg. You can see in this
demonstration that the interventional cardiologist is gaining access to the femoral artery by a small
bore needle through which a wire is passed then a short sheath is inserted over the wire.
Similarly access to the circulation might be gained through the radial artery
which is shown in this illustration.
You can also see the cardiologists obtaining access through this artery as well.
Through the sheath in the femoral artery or the radial artery, longer catheters are
passed up all the way to the heart over a longer wire guided by the x-ray machine.
The image shows different catheter types that we use regularly. When performing this procedure
the tip of one of these catheters is then guided to the opening or origin of one of the coronary
arteries of the heart and a contrast material is ejected. The blockage can then be easily seen
on the screen. On the left hand side of the screen, you can see in the video that there
is a clear blockage in the middle of the right coronary artery when the contrast is injected.
A special wire is then passed through the blockage. This wire is known as the guide wire.
You can see in this video that the wire has been passed through the blockage.
Over this wire a small balloon is then passed and dilates the blockage.
This is how it looks like when i am performing this procedure.
After the narrowing has been dilated, the balloon is withdrawn and the stent is then passed over
the wire to the area of the blockage. This is how the stent looks. The stent comes pre-packaged
and mounted onto a delivery balloon as shown. The stent is then delivered to the narrowed artery and
deployed to keep the artery open. This is how it looks to me during the procedure.
And this is how it is expected to show anatomically.
After the stent is secured in place a check shot of contrast shows that the blockage
is no longer there as you can see in this angiogram.
The catheters and wires are then removed from the heart and the short tube in the femoral artery or
the radial artery is then removed the bleeding from the access site is controlled by manual
compression and the patient is then taken to the coronary care unit for observation.
Generally the following day if the patient has been stable after the procedure the
patient undergoes education about the possible complications that might arise
and about the new medications that would be started to keep the stent
open. All the patients questions are answered and the patient is then discharged to be followed
in the outpatient clinic, generally in four to six weeks.
If you have any question about what I presented to you today or any cardiology question in general,
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this is Dr Bolad helping you with your heart health, thanks for watching and talk to you soon.
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