WHERE DOES THE MINIMALLY INVASIVE | |||||||||||
APPROACH IN PCI START ? | |||||||||||
The contemporary approach for arterial | |||||||||||
access in PCI is transradial access ( TRA ). | |||||||||||
A small sheath is inserted through the radial | |||||||||||
artery at the wrist using local anaesthesia – reducing bleeding , vascular complications and improving patient comfort compared to the traditional transfemoral access ( TFA ) through the groin . |
CORONARY IMAGING
CAN I OPTIMISE MY STENTING RESULTS ? Intracoronary imaging can greatly improve the final result of the PCI . Advanced imaging catheters such as Intravascular Ultrasound
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( IVUS ) and Optical Coherence Tomography | |||||||||||
CORONARY PHYSIOLOGY |
( OCT ) are used within the coronary arteries |
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DOES THIS NARROWING NEED TO |
to |
accurately |
visualise |
the |
vessel |
size , |
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BE STENTED ? If a coronary angiogram shows severe narrowing , most cardiologists will perform a PCI . If there is minimal narrowing , PCI |
characteristics of the narrowing , and help in precise sizing and placement of the stent . Scientific data show that using intracoronary imaging improves stenting results for better |
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is |
not |
required . |
For |
an |
intermediate |
long-term patient outcomes . |
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narrowing , a Fractional Flow Reserve ( FFR ) | |||||||||||
can objectively determine whether this narrowing requires PCI . Using an ultra-thin wire with a sensor inside the coronary artery , the pressure before and after the narrowing is compared . If there is a significant drop in pressure indicating poor blood flow , PCI is recommended . A modest drop in pressure indicates the narrowing is better off treated with medications . |
CALCIUM TREATMENT
FIGHTING CALCIUM IN THE ARTERIES Heavily calcified narrowing is one of the toughest to treat . Calcification occurs as part of atherosclerosis ( cholesterol plaque build-up ) and is often seen in the elderly ; patients with renal failure ; and diabetics . A conventional balloon is often inadequate to crack open the rock-hard calcium . A highly
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Dr Joshua Loh is a Senior Consultant | |||||||||||
Interventional Cardiologist with | |||||||||||
more than 10 years of experience | |||||||||||
in the field . He has extensive | |||||||||||
experience with complex coronary |