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Depending on the number, severity and location of these obstructions, the physician may refer the patient for medical therapy, bypass surgery, or, if appropriate, may treat the patient directly, using catheter-based techniques. These options are discussed with the patient after the diagnostic catheterization.

Upon occasion, the cardiologist may suggest transforming the diagnostic test on the spot into a therapeutic procedure which, since the arterial "highway" has already been traversed, can be done, adding abo-ut an hour to the session.

 

cath lab Cardiologist looks at
fluoroscopic monitor
during procedure


PTCA animation
A guide wire is placed across the lesion and a
balloon is inflated, in this case twice.
 

The cardiologist places a more versatile catheter into the opening of the coronary artery. A thin wire is threaded through this catheter and well past the narrowing, or stenosis, in the artery. A "rail" or track has now been established and any number of therapeutic devices (in this illustration, a balloon) can be passed safely over the wire and positioned precisely at the obstruction.

As the blockage is opened, blood flow in the artery is stopped for very brief periods, during which the patient may experience some chest pain. This is normal.

When the procedure is over, all equipment is removed, the puncture site is compressed in order to heal, and the patient usually can return home within a day or two. For many patients, the most uncomfortable part is the several hours post-procedure, when they need to lie still for the puncture site compression. Several devices, or "sealers", are now being utilized to reduce this period significantly.

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