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Treatments for Coronary Artery Disease

Treatments for Coronary Artery Disease. Medicine PTCA CABG. Medicine. Types of medicines used in coronary artery disease. drugs to prevent clot formation drugs to break down clots already formed cholesterol-lowering drugs blood pressure medications.

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Treatments for Coronary Artery Disease

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  1. Treatments for Coronary Artery Disease Medicine PTCA CABG

  2. Medicine

  3. Types of medicines used in coronary artery disease • drugs to prevent clot formation • drugs to break down clots already formed • cholesterol-lowering drugs • blood pressure medications

  4. When do we treat coronary disease with MEDICINE only? • stable coronary artery disease • no high risks for heart attack

  5. What is PTCA? • Percutaneous (through the skin) transluminal (inside the blood vessel) coronary (relating to the heart) angioplasty (blood vessel repair).  • balloon angioplasty • When a stent is also used, the procedure is called a Percutaneous Coronary Intervention (PCI). • stenting

  6. Balloon Angioplasty

  7. Stents • self expandable • balloon expandable • drug eluting

  8. Drug Eluting Stents • Paclitaxel • Sirolimus (Rapamycin) • Heparin • Angiopeptin • Abciximab • Phosphorylcholine • Poly-l-lactic stent • Hybrid revascularization

  9. Restenosis • after angioplasty, the vessel begins to heal, the artery contracts, and the lumen narrows • restenosis is more likely to occur after POBA (balloon angioplasty) than after stenting

  10. When do we treat coronary disease with PTCA (Angioplasty or Stent)? • stable coronary artery disease with risks • previous heart attack • failed medication • 1 or 2 coronary arteries involved

  11. If stents are more effective than balloon angioplasty, why not always use a stent? • Stents are difficult to deliver across tight bends in blood vessels (particularly if they have a lot of calcium deposits in the wall) and are not usable in very small blood vessels. There are other types of technical considerations that also come into play. Today, it is estimated that stents are employed in nearly 50-75% of cases.

  12. CABG Coronary Artery Bypass Graft

  13. vessels used for CABG • internal mammary artery • radial artery • great saphenous vein

  14. radial artery

  15. IMA= internal mammary artery RA = radial artery SVG = great saphenous vein

  16. CABG procedure types • heart lung machine • off-pump bypass graft • stabilizer

  17. When do we treat coronary disease with CABG? • multiple coronary arteries involved • left main coronary artery affected • patient requires valve surgery also • Diabetes Mellitus • poor left ventricular function • recurrent restenosis after PCI

  18. VIDEO • http://www.youtube.com/watch?v=jlNjyJgi5WA

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