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| PTCA
- INTERVENTION PROCEDURE, SPECIFICITY AT OUR CLINIC |
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K. Kadrović, Dž. Hrustemović, J. Muminović and S. Spasojević |
| Clinic
of Cardiology, Clinical Center University of Sarajevo, Bosnia
and Herzegovina |
PTCA - Percutaneous transluminal coronary angioplasty
is an invasive technique aiming to reduce the stenoses caused
by atherosclerosis of the coronary vessels.It is the alternative
solution to coronary bypass operation.PTCA is advantageous procedure
in cases of single lesions on one or more vessels.It is a complex
method requiring radiological and physiological follow up of the
patients, wide spectrum of material and very well educated medical
personnel.It also requires parallel stand by of cardiac surgery
and anesthesiology.In our conditions the compulsory preconditions
for performing the interventional cardiology treatment have been
theorecitally fulfilled.Practically the clinic of radiology, where
the catheterisation laboratory is situated, is physically divided
from the clinic of cardiology and cardiac surgery.Therefore it
requires extremely well prepared stand by arrangements and staff
in order to meet limited demands of cardiac emergency. The necessary
guiding catheter is introduced into the femoral artery through
the sheath.Then, a special wire, which has to pass the given stenoses,
is introduced.During the procedure the catheters have to be flushed
with heparin added saline.Also the solution of nitroglycerin have
to be always prepared beforehand since there are no ready-made
solutions at our market.After the balloon is placed over the wire
into desired position, it is inflated with indeflator for certain
period of time, depending on the type of the stenoses.Similarly
the stent is placed over the wire and opened with indeflator.
Afterwards all the patients are put on the treatment with Aspirin,
in combination or not with Ticlopidine and they are referred to
the intensive care unit. The sheats are withdrawn after 4-6 hours
and the patients can be discharged after 24 hours.The situation
would be different in case of emergency PTCA which has not been
yet performed routinely due to the specific circumstances. Conclusion:
The necessary preconditions for performing the PTCA procedure
must be met although at our clinic there are certain specifiticies
which must not be neglected .
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