Sample Report Percutaneous Transluminal Coronary Angioplasty
Title of Procedure: Percutaneous transluminal coronary angioplasty (PTCA) of the left anterior descending (LAD).
Procedure in Detail: The patient was prepped and draped in the usual fashion. The left femoral artery was chosen because of recent cardiac catheterization from the right side with use of VasoSeal. A 7 French sheath was placed in the left femoral artery and 6 French in the left femoral vein over the wire with Seldinger technique. A diagnostic left coronary angiogram was performed, using a 6 French JL4 catheter, which was advanced over a wire to the left coronary ostium. It revealed no change in the mid-LAD lesion. A 7 French short-tip JL4 guide without side holes was then advanced to the left coronary ostium over the wire, after the regular-tip JL4 could not engage the left coronary ostium satisfactorily. A 0.014-inch Patriot wire with a Ranger 2.5 × 20-mm balloon was advanced as a unit in the guide. Heparin 10,000 units was given IV. Activated coagulation time before the procedure was 350 seconds. The wire was advanced across the lesion without difficulty, and initial PTCA was accomplished with a 2.5-mm Ranger balloon inflated to four atmospheres for 25 seconds and then six atmospheres for 60 seconds. Angiogram after this revealed less than 10% residual lesion, but in the left anterior oblique cranial view a nonocclusive dissection limited to the lesion with extravascular dye staining was noted. Therefore, a decision was made to proceed with stenting. A 2.5 × 16-mm NIR with SOX stent was advanced across the lesion and deployed at 11 atmospheres. A poststent angiogram revealed a 0% residual lesion, no evidence of dissection visible, TIMI-III flow, and the closing ACT was 335 seconds. There were no complications.
Procedure in Detail: The patient was prepped and draped in the usual fashion. The left femoral artery was chosen because of recent cardiac catheterization from the right side with use of VasoSeal. A 7 French sheath was placed in the left femoral artery and 6 French in the left femoral vein over the wire with Seldinger technique. A diagnostic left coronary angiogram was performed, using a 6 French JL4 catheter, which was advanced over a wire to the left coronary ostium. It revealed no change in the mid-LAD lesion. A 7 French short-tip JL4 guide without side holes was then advanced to the left coronary ostium over the wire, after the regular-tip JL4 could not engage the left coronary ostium satisfactorily. A 0.014-inch Patriot wire with a Ranger 2.5 × 20-mm balloon was advanced as a unit in the guide. Heparin 10,000 units was given IV. Activated coagulation time before the procedure was 350 seconds. The wire was advanced across the lesion without difficulty, and initial PTCA was accomplished with a 2.5-mm Ranger balloon inflated to four atmospheres for 25 seconds and then six atmospheres for 60 seconds. Angiogram after this revealed less than 10% residual lesion, but in the left anterior oblique cranial view a nonocclusive dissection limited to the lesion with extravascular dye staining was noted. Therefore, a decision was made to proceed with stenting. A 2.5 × 16-mm NIR with SOX stent was advanced across the lesion and deployed at 11 atmospheres. A poststent angiogram revealed a 0% residual lesion, no evidence of dissection visible, TIMI-III flow, and the closing ACT was 335 seconds. There were no complications.
Advertising