Surgery - Endovascular Procedures
Indications minimally invasive techniques, often known as "interventional radiology," are used to diagnose and treat venous or artery diseases endoscopically. carried out by a variety of specialists, such as gastroenterologists, cardiologists, neurosurgeons, radiologists, and vascular surgeons. Endovascular procedures include : Angioplasty and stents for arterial occlusive disease, such as those in the leg, renal, iliac, coronary, or carotid arteries. Stenting of aneurysms, e.g. EVAR and popliteal aneurysms.coil embolization of aneurysms, such as those in the brain. coil embolization of bleeding vessels, such as the duodenal artery when bleeding from a duodenal ulcer. coil embolization of veins that have dilated, such as pelvic varicose veins and varicocoele. catheter-directed thrombolysis or thrombectomy. tissue embolization, such as liver metastases through chemotherapy or embolization of uterine fibroids. Shunts: in portal hypertension, transjugular intrahepatic portosystemic shunts (TIPS). Filters: To avoid a venous embolism: vena cava inferior filters. Vein ablation: Radiofrequency ablation of varicose veins or endovenous laser therapy (EVLT). Benefits include: less pain; fewer incisions, frequently just a puncture wound; local anesthesia as opposed to general anesthesia; lower morbidity and mortality, particularly in the heart and lungs; and quicker recovery. Actions Access: The local anesthetic enters the body. Under ultrasound guidance, a guidewire and catheter are percutaneously cannulated and placed, usually into the femoral vein for venous circulation and the groin for arterial circulation. Options include the popliteal or subclavian arteries, or less frequently, the brachial or axillary arteries. The lower leg is used to access the long saphenous vein during treatment for varicose veins. If device implantation is to be done, antibiotics are given. Navigation: A large variety of catheters and guidewires are available. The area of circulation under inquiry or treatment can be selectively catheterized thanks to experience, expertise, and knowledge of anatomy and imaging. Radio-opaque contrast is injected during an angiography procedure in order to plan, direct, and evaluate therapy. Angioplasty: Lesion distance from access site, stenosis length, and native artery size are taken into consideration when choosing balloon catheters. Following the insertion of the balloon over the lesion, inflation of the balloon is carried out using contrast to enable fluoroscopic observation of the balloon's contour during dilatation, along with the monitoring of inflation pressures. Stents: They can be self-expanding or balloon mounted. Stents come in many varieties, including as coated, drug-eluting, and baremetal. Certain types of stents, such as those put in the carotid artery, use embolic protection devices to trap plaque fragments that have come loose and could embolize and result in stroke. Stent graft: An EVAR technique in which grafts are held up by a stiff stent framework. Coils: Usually composed of nitinol, tungsten, or platinum. The coil is advanced to the intended intravascular site through the microcatheter by a delivery wire, often known as a "coil pusher." After being deployed, the flexible coils return to their former shape, preventing additional blood flow into the aneurysm or vessel. Closure: The percutaneous catheter is removed, and the site is compressed manually or with the help of closure equipment. Complications Entry point: bleeding, pseudoaneurysm, arteriovenous fistula, infection in the groin, blockage of a vascular. In the vessel during the insertion of a wire or catheter: embolism, perforation, false plane, and thrombosis. Dissection, rethrombosis, intimal flap, perforation, restenosis, endoleak, graft infection, and stent migration can all occur at the intervention site. Thrombosis and embolism are downstream.
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