Interventional Cardiology: Difference between revisions

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Latest revision as of 19:24, 25 July 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Diagnostic Catheterization | Risk Stratification and the Benefits of PCI vs Medical Therapy | Conscious Sedation | Preparation of the Patient for Diagnostic Catheterization | Technical Aspects of the Cardiac Catheterization Laboratory | Obtaining Venous and Arterial Access | Equipment Used in Diagnostic Cardiac Catheterizaiton | Hemodynamic Assessment in the Cardiac Catheterization Laboratory | Radiation Safety

Therapeutic Catheterization | Therapeutic procedures | Advances in catheter based physical treatments

PCI | Preparation of the Patient for Percutaneous Coronary Intervention (PCI) | Percutaneous Coronary Intervention (PCI): Basic Principles and Guidelines | Equipment Used in Percutaneous Coronary Intervention | Pharmacotherapy to Support PCI | Antiplatelet therapy | Antithrombotic therapy | Angiography and PCI in Special Patient Populations | Management Of Specific Lesion Types | High Risk Percutaneous Coronary Intervention (PCI) | Vascular Closure Devices | Post PCI Medical Management of the Interventional Patient | Complications During and Following Cardiac Catheterization and Percutaneous Coronary Intervention | Coronary stent thrombosis

PCI in Specific Populations and Lesion Types

High Risk PCI | PCI in the Patient in Cardiogenic Shock | PCI in the Patient Requiring CPR and Refractory Ventricular Arrhythmias | PCI in the Patient with Severely Depressed Ventricular Function | PCI in the Patient with Critical Valve Stenosis | PCI in the Sole Remaining Conduit | PCI in the Unprotected Left Main Patient | Adjuncts for High Risk Percuatenous Coronary Intervention

Mechanical circulatory support | Mechanical circulatory support | Intra-aortic balloon pump | Ventricular assist devices | Artificial heart

Left Ventriculography | Technique | Quantification of LV Function | Quantification of Mitral Regurgitation

Other TopicsNon Coronary Interventions in the Cardiac Catheterization Laboratory | Transfusion in ACS management | Revascularization in the "No Option" Patient

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 {{CMG}}
+<small>'''Diagnostic Catheterization''' | [[Risk Stratification and the Benefits of PCI vs Medical Therapy]] | [[Conscious Sedation]] | [[Preparation of the Patient for Diagnostic Catheterization]] | [[Technical Aspects of the Cardiac Catheterization Laboratory]] | [[Obtaining Venous and Arterial Access]] | [[Equipment Used in Diagnostic Cardiac Catheterizaiton]] | [[Hemodynamic Assessment in the Cardiac Catheterization Laboratory]] | [[Radiation Safety]]</small>
-===[[Risk Stratification and the Benefits of PCI vs Medical Therapy]]===
+<small>'''Therapeutic Catheterization''' | [[Coronary angiography therapeutic procedures|Therapeutic procedures]] | [[Coronary angiography advances in catheter based physical treatments|Advances in catheter based physical treatments]] </small>
-===[[Conscious Sedation]]===
+<small>'''Coronary angiography''' | [[Coronary angiography overview|Overview]] | [[Coronary angiography historical perspective| Historical Perspective]] | [[Coronary angiography contraindications|Contraindications]] | [[Appropriate use criteria for revascularization]] | [[Coronary angiography complications|Complications]] | [[Coronary angiography technique|Technique]] | [[Coronary angiography film quality|Film Quality]]</small>
-===[[Preparation of the Patient for Diagnostic Catheterization]]===
+<small>'''Coronary Anatomy and Projection Angles''' | '''''Normal Coronary Anatomy''''' | [[Coronary arteries]] | [[Left coronary artery]] | [[Left main coronary artery]] | [[Left anterior descending artery]]  |  [[Left circumflex artery]] | [[Ramus intermedius]] | [[Right coronary artery]] | [[Coronary artery dominance]] | '''''Coronary Anatomic Variants''''' | [[Separate ostia]] | [[Anomalous origins of the coronary arteries]] | [[Coronary artery fistula]] | '''''Projection Angles''''' | [[Coronary angiography standard views|Standard angiographic views]] | [[Coronary angiography left coronary artery|Left coronary artery]] | [[Coronary angiography right coronary artery|Right coronary artery]] </small>
-===[[Preparation of the Patient for Percutaneous Coronary Intervention (PCI)]]===
+<small> '''Assessment of Epicardial Coronary Blood Flow''' | [[TIMI flow grade|TIMI flow grade (TFG)]] | [[TIMI flow grade 0]] | [[TIMI flow grade 1]] | [[TIMI flow grade 2]] | [[TIMI flow grade 3]] | [[TIMI frame count (TFC)]] | [[Pulsatile flow]] | [[Deceleration]] </small>
-===[[Technical Aspects of the Cardiac Catheterization Laboratory]]===
+<small> '''Assessment of Myocardial Perfusion''' | [[TIMI Myocardial Perfusion Grade|TIMI myocardial perfusion grade (TMPG)]] | [[TIMI myocardial perfusion grade 0]] | [[TIMI myocardial perfusion grade 0.5]] | [[TIMI myocardial perfusion grade 1]] | [[TIMI myocardial perfusion grade 2]] | [[TIMI myocardial perfusion grade 3]] </small>
-===[[Obtaining Venous and Arterial Access]]===
+<small>'''Assessment of Coronary Lesions''' | [[Coronary Fractional Flow Reserve (FFR)]]) | [[Coronary flow reserve]]([[CFR]]) | [[Intravascular ultrasound]] ([[IVUS]]) | '''''Lesion Complexity''''' | [[Coronary angiography ACC-AHA characteristics of type A, B, and C coronary lesions|ACC-AHA characteristics of type A, B, and C coronary lesions]] | [[Coronary angiography SCAI lesion classification system|SCAI Lesion Classification System]]
-===[[Equipment Used in Diagnostic Cardiac Catheterizaiton]]===
+'''''Thrombus Grades''''' | [[PERFUSE thrombus grade|TIMI thrombus grade]] | [[PERFUSE thrombus grade 0|TIMI thrombus grade 0]] | [[PERFUSE thrombus grade 1|TIMI thrombus grade 1]] | [[PERFUSE thrombus grade 2|TIMI thrombus grade 2]] | [[PERFUSE thrombus grade 3|TIMI thrombus grade 3]] | [[PERFUSE thrombus grade 4|TIMI thrombus grade 4]] | [[PERFUSE thrombus grade 5|TIMI thrombus grade 5]] | [[PERFUSE thrombus grade 6|TIMI thrombus grade 6]] | '''''Lesion Morphology''''' | [[Coronary angiography quantitative angiography|Quantitative angiography]] | [[Quantitative coronary angiography#Definitions of Preprocedural Lesion Morphology|Definitions of Preprocedural Lesion Morphology]] | Irregular lesion | Disease extent | Arterial foreshortening | [[Infarct related artery]] ([[Culprit lesion]]) | [[Restenosis]] | Degenerated saphenous vein graft | [[Collaterals]] | [[Coronary artery ulceration]] | [[Coronary artery aneurysm]] | [[Coronary artery bifurcation]] | [[Coronary artery trifurcation]]</small>
-===[[Hemodynamic Assessment in the Cardiac Catheterization Laboratory]]===
+<small>'''PCI''' | [[Preparation of the Patient for Percutaneous Coronary Intervention (PCI)]] | [[Percutaneous Coronary Intervention (PCI): Basic Principles and Guidelines]] | [[Equipment Used in Percutaneous Coronary Intervention]] | [[Pharmacotherapy to Support PCI]] | [[Antiplatelet therapy]] | [[Antithrombotic therapy]] | [[Angiography and PCI in Special Patient Populations]] | [[Management Of Specific Lesion Types]] | [[High Risk Percutaneous Coronary Intervention (PCI)]] | [[Vascular Closure Devices]] | [[Post PCI Medical Management of the Interventional Patient]] | [[Complications During and Following Cardiac Catheterization and Percutaneous Coronary Intervention]] | [[Coronary stent thrombosis]]
-===[[Percutaneous Coronary Intervention (PCI): Basic Principles and Guidelines]]===
+'''PCI in Specific Populations and Lesion Types'''
+*[[Coronary angiography ACC-AHA characteristics of type A, B, and C coronary lesions|Assessment of Lesion Complexity and Morphology Using Coronary Lesion Classification Systems]]
+*[[PCI in the Patient with Angiographically Visible Thrombus|Angiographically Visible Thrombus]]
+*[[PCI in the Calcified Lesion|The Calcified Leison]]
+*[[PCI in the Ostial Lesion|The Ostial Lesion]]
+*[[PCI in the Angulated or Tortuous Lesion|The Angulated or Tortuous Lesion]]
+*[[PCI in the Bifurcation Lesion|Management of the Bifurcation Lesion]]
+*[[PCI in the Long Lesion|The Long Lesion]]
+*[[Myocardial bridge|Management of a Coronary Bridge Lesion and Kinks]]
+*[[PCI in the Patient with Coronary Vasospasm|Management of Coronary Vasospasm]]
+*[[PCI in the Patient with a Chronic Total Occlusion|The Chronic Total Occlusion (CTO)]]
+*[[PCI in Small Vessels|Intervention in Small Vessels]]
+*[[PCI in Diffusely Diseased Vessels|Intervention in Diffusely Diseased Vessels]]
+*[[Intervention in Saphenous Vein Grafts (SVG)|Intervention in Saphenous Vein Grafts (SVG)]]
+*[[PCI in the Left Internal Mammary Artery|Intervention in the LIMA]]
+*[[PCI in the Right Internal Mammary Artery|Intervention in the RIMA]]
+*[[PCI in a Free Radial Artery or Other Conduit|Intervention in a Free Radial and other Conduits]]
+*[[Multivessel PCI|Multivessel Intervention]]
+*[[PCI in the Patient with Restenosis|PCI in the Patient with Restenosis]]
+*[[Stent Thrombosis|Management of the Patient with Stent Thrombosis]]
+*[[Treatment of Distal Anastomotic Lesions|Treatment of Distal Anastomotic Lesions]]
+*[[Coronary Artery Perforation|Coronary Artery Perforation]]
+*[[Left Main Intervention|Left Main Intervention]]
+*[[Management of the Thrombotic Lesion|Management of the Thrombotic Lesion]]
-===Functional assesement of coronary lesions===
+</small>
-====[[Coronary Fractional Flow Reserve (FFR)]])====
+<small>'''High Risk PCI''' | [[PCI in the Patient in Cardiogenic Shock|PCI in the Patient in Cardiogenic Shock]]  |  [[PCI in the Patient Requiring CPR and Refractory Ventricular Arrhythmias|PCI in the Patient Requiring CPR and Refractory Ventricular Arrhythmias]] | [[PCI in the Patient with Severely Depressed Ventricular Function|PCI in the Patient with Severely Depressed Ventricular Function]] | [[PCI in the Patient with Critical Valve Stenosis|PCI in the Patient with Critical Valve Stenosis]] | [[PCI in the Sole Remaining Conduit|PCI in the Sole Remaining Conduit]] | [[PCI in the Unprotected Left Main Patient|PCI in the Unprotected Left Main Patient]] | [[Adjuncts for High Risk Percuatenous Coronary Intervention|Adjuncts for High Risk Percuatenous Coronary Intervention]]</small>
-====[[Coronary flow reserve]]([[CFR]])====
+<small>'''Mechanical circulatory support''' | [[Mechanical circulatory support]] | [[Intra-aortic balloon pump]] | [[Ventricular assist device|Ventricular assist devices]] | [[Artificial heart]] </small>
-====[[Intravascular ultrasound]] ([[IVUS]]) ====
+<small>'''PCI Complications''' | [[PCI complications: vessel perforation|Vessel Perforation]] | [[PCI complications: dissection|Dissection]] | [[PCI complications: distal embolization|Distal Embolization]] | [[PCI complications: no reflow|No-reflow]] | [[PCI complications: abrupt closure|Abrupt Closure]] | [[PCI complications: restenosis|Restenosis]] | [[PCI complications: late acquired stent malapposition|Late Acquired Stent Malapposition]] | [[PCI complications: loss of side branch|Loss of Side Branch]] | [[PCI complications: multiple complications|Multiple Complications]] | [[Coronary stent thrombosis]] | [[Slow flow]] | [[Pulsatile flow]] | [[Deceleration]] | [[Ectasia]] | [[Intimal flap]] | Staining | [[Coronary air embolism]] </small>
-===[[Equipment Used in Percutaneous Coronary Intervention]]===
+<small> '''Left Ventriculography''' | [[Left ventriculography#Technique|Technique]] | [[Left ventriculography#Quantification of Left Ventricular Function|Quantification of LV Function]] | [[Left ventriculography#Quantification of LMitral Regurgitation|Quantification of Mitral Regurgitation]] </small>
-===[[Pharmacotherapy to Support PCI]]===
+<small>'''Other Topics'''[[Non Coronary Interventions in the Cardiac Catheterization Laboratory]] | [[Transfusion in ACS management]] | [[Revascularization in the "No Option" Patient]]</small>
+<br>
-===[[Angiography and PCI in Special Patient Populations]]===
-===[[Management Of Specific Lesion Types]]===
-===[[High Risk Percutaneous Coronary Intervention (PCI)]]===
-===Hybrid Procedures===
-===[[Vascular Closure Devices]]===
-===[[Post PCI Medical Management of the Interventional Patient]]===
-===[[Non Coronary Interventions in the Cardiac Catheterization Laboratory]]===
-===[[Complications During and Following Cardiac Catheterization and Percutaneous Coronary Intervention]]===
-===[[Coronary stent thrombosis]]===
-===[[Transfusion in ACS management]]===
-===[[Revascularization in the "No Option" Patient]]===
-===[[Radiation Safety]]===
-----
-'''Interventional cardiology''' is a branch of the [[medicine|medical]] specialty of [[cardiology]] that deals specifically with the catheter based treatment of structural [[heart disease]]s.
-A large number of procedures can be performed on the [[heart]] by [[coronary catheterization|catheterization]]. This most commonly involves the insertion of a sheath into the [[femoral artery]] (but, in practice, any large peripheral artery or vein) and cannulating the heart under [[X-ray]] visualization (most commonly [[fluoroscopy]], a real-time x-ray).
-Procedures performed by specialists in interventional cardiology:
-* [[Angioplasty]] (PTCA, Percutaneous Transluminal Coronary Angioplasty) - for [[coronary artery|coronary]] [[atherosclerosis]]
-* Valvuloplasty - dilation of narrowed cardiac valves (usually mitral, aortic or pulmonary)
-* Procedures for congenital heart disease - insertion of occluders for ventricular or atrial septal defects, occlusion of patent ductus arteriosus, angioplasty of great vessels
-* Emergency angioplasty and stenting of occluded coronary vessels in the setting of acute myocardial infarction
-Invasive procedures of the heart to treat arrhythmias are performed by specialists in [[clinical cardiac electrophysiology]]
-Surgery of the heart is done by the specialty of [[cardiothoracic surgery]]. Some interventional cardiology procedures are only performed when there is cardiothoracic surgery expertise in the hospital, in case of complications.
-==See also==
-* [[Interventional radiology]]
-* [[Catheter]]
-* [[Cannula]]
-* [[Stent]]
-* [[Restenosis]]
-==External links==
-* [http://www.clinicaltrialresults.org ClinicalTrialResults.org]
-* [http://www.angioplasty.org Angioplasty.Org]
-* [http://www.europcronline.com EuroPCROnline.com]
-* [http://www.tctmd.com/csportal/appmanager/tctmd/main tctmd.com]
+{{Coronary Angiography}}
 [[Category:Cardiology]]

v t e Coronary Angiography
Coronary Anatomy	Normal coronary anatomy • Anomalous origins of coronary arteries (Left coronary artery • Right coronary artery) • Congenital abnormalities of coronary arteries • Coronary artery segments • Cinefilm frame speed • Coronary artery dominance (Left dominance • Right dominance • Co-dominance)
TIMI Flow Grade	TIMI flow grade 0 • TIMI flow grade 1 • TIMI flow grade 2 • TIMI flow grade 3
TIMI Frame Count	TFC for SVG • TIMI Myocardial Frame Count • Washout TIMI Frame Count
TIMI Myocardial Perfusion Grade	TIMI MPG 0 • TIMI MPG 1 • TIMI MPG 2 • TIMI MPG 3
Thrombus Grading	Thrombus Grade 0 • Thrombus Grade 1 • Thrombus Grade 2 • Thrombus Grade 3 • Thrombus Grade 4 • Thrombus Grade 5 • Thrombus Grade 6
Lesion Complexity	Type A • Type B₁ • Type B₂ • Type C
Dissection Classification	Type A • Type B • Type C • Type D • Type E • Type F
Coronary Collaterals	Grade 0 • Grade 1 • Grade 2 • Grade 3 • Rentrop and Cohen’s Collateral Classification
Lesion Morphology	Myocardial bridge •Definitions of Preprocedural Lesion Morphology • Luminal irregularities • Disease extent • Arterial foreshortening • Infarct related artery (Culprit lesion) • Reocclusion • Restenosis • Degenerated saphenous vein graft • Coronary artery fistula
Angiographic complications	Distal embolization • Coronary spasm • Abrupt closure • Side branch loss • Slow flow • No-reflow • Pulsatile flow • Flow deceleration • Ectasia • Intimal flap • Staining •
Performing Coronary Angiography	Patient preparation • Catheter selection • Standard angiographic views • High risk groups • Patients with special need • Access site closure (Manual compression • Assisted compression • Closure devices) •
Quantitative Coronary Angiography (QCA)	Minimal lumen diameter • Percent stenosis • Reference diameter • Lesion length • Residual stenosis • Average reference segment diameter • Plaque area • Plaque volume •
Contrast Media	High-osmolar contrast media • Iso-osmolar contrast media • Low-osmolar contrast media
Left Ventriculography & Aortography	Ejection fraction • Aortography • Quantitative Left Ventricular Analysis (LAO projection • RAO projection • LVA) • Left Ventricular Wall Motion Analysis (Normokinesia • Hypokinesia • Akinesia • Dyskinesia • Aneurysm) • Evaluation of mitral regurgitation • Evaluation of aortic regurgitation
Right Heart Catheterization	Pressure waveforms (Right atrial pressure • Rirght ventricular pressure • Pulmonary artery pressure • Pulmonary artery wedge-pressure) • Endomyocardial biopsy
Complications	Access site complications • Dumping • Contrast hypersensitivity • Contrast induced nephropathy • Hypotension • Hypertension • Dissection • Vessel perforation • Acute myocardial infarction • Ventricular fibrillation • Cardiac arrest • Stroke • ASD • VSD • Pulmonary emboli • Myocardial rupture • Peripheral arterial emboli • Radiation injury

Interventional Cardiology: Difference between revisions

Latest revision as of 19:24, 25 July 2014

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