percutaneous transluminal angioplasty

Percutaneous transluminal angioplasty (PTA) is a series of techniques for forming a balloon catheter into a narrow blood vessel using a Seldinger technique. The scope of angioplasty includes: 1 vascular thrombolysis; 2 balloon angioplasty; 3 plaque resection; 4 laser angioplasty; 5 internal stenting. Curing disease: Indication Percutaneous transluminal angioplasty is suitable for: 1. Tumor compression and erosion of blood vessels cause stenosis or occlusion. 2. Various causes of stenosis or occlusion of blood vessels. Contraindications 1. Severe bleeding tendency. 2. The guide wire and catheter cannot pass through the narrow part. 3. The vascular stenosis is too long. 4. The blood vessels are severely ruptured by tumor erosion. 5. The blood vessel wall is obviously calcified. Preoperative preparation 1. Clean the skin. 2. Do an iodine allergy test. 3. Talk to the patient before surgery and sign the surgery. 4. Local color Doppler ultrasonography to understand the length of stenosis, stenosis, surrounding tumor tissue infiltration and compression. 5. Prepare balloon catheters and related instruments of corresponding size and length according to the results of the examination. Surgical procedure 1. Puncture cannula was performed using the Seldinger technique. 2. Aortic or vena cava angiography to understand the stenotic opening and surrounding blood vessels. 3. Under the guidance of the guide wire, selectively introduce the catheter into the stenosis area to further understand the length and width of the stenosis. 4. Measure the pressure at both ends of the stenosis and record. 5. Use the super-sliding guide wire to pass through the stenosis, and then introduce the balloon catheter into the guide wire. If it is difficult, use a super-hard guide wire to assist, or use a small balloon catheter to pre-expand the stenosis. 6. Place the prepared balloon catheter in a narrow place, use a syringe to draw 30% of the contrast agent into the balloon, and gently expand it. Under fluoroscopy, observe whether the position of the balloon catheter is exactly at the stenosis, and adjust the position. The pressure injection expands the balloon and the impression disappears. 7. A few minutes after the contrast agent is withdrawn, it is injected into the balloon, and the pressure is repeated for 10 to 15 seconds each time, and repeated 3 to 4 times. 8. Exit the balloon catheter and compare before and after angiography. 9. Re-measure the pressure at both ends of the stenosis and compare it with the preoperative expansion. 10. Injecting 2000 U of heparin every 2 hours during surgery, aimed at heparinization. complication 1. Due to the application of a larger amount of heparin during surgery, the incidence of hemorrhage and hematoma formation at the puncture site is higher, local compression dressing is prevented, and the patient is rubbed for 24 hours. 2. If thrombosis occurs in the blood vessels after expansion, catheter thrombolysis should be performed immediately. 3. If the intima of the artery is severed and the cutting is severe after the expansion, the stent should be quickly placed through the catheter. 4. Vascular rupture requires urgent surgical treatment.