Short Communication, Int J Cardiol Res Vol: 13 Issue: 1

Angioplasty: A Comprehensive Review of Techniques, Complications, and Advancements

Daizu Funatsu^*

¹Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil

*Corresponding Author: Daizu Funatsu,
Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil
E-mail: funatsud@hc.fm.usp.br

Received date: 29 January, 2024, Manuscript No. ICRJ-24-134231;

Editor assigned date: 31 January, 2024, PreQC No. ICRJ-24-134231 (PQ);

Reviewed date: 14 February, 2024, QC No. ICRJ-24-134231;

Revised date: 21 February, 2024, Manuscript No. ICRJ-24-134231 (R);

Published date: 28 February, 2024, DOI: 10.4172/2324-8602.1000541.

Citation: Funatsu D (2024) Angioplasty: A Comprehensive Review of Techniques, Complications, and Advancements. Int J Cardiol Res 13:1.

Description

In the field of cardiovascular medicine, angioplasty stands as a pivotal intervention, revolutionizing the treatment of Coronary Artery Disease (CAD) and other vascular occlusions. With its inception in the late 1970s, angioplasty has evolved into a sophisticated procedure, offering patients a minimally invasive alternative to traditional surgery. The origins of angioplasty trace back to the groundbreaking work of a German radiologist who performed the first successful balloon angioplasty in 1977 [1,2]. Innovative technique involved inflating a small balloon within a narrowed artery to dilate the obstruction and restore blood flow. This seminal achievement laid the foundation for the development of Percutaneous Coronary Intervention (PCI), a procedure that has since become a cornerstone in the management of CAD.

Techniques of angioplasty

Modern angioplasty techniques encompass a spectrum of approaches tailored to the specific characteristics of the lesion and patient anatomy. The procedure typically begins with arterial access, commonly via the femoral or radial artery, followed by the insertion of a guidewire and catheter into the target vessel under fluoroscopic guidance. Once positioned, a balloon catheter is advanced over the guidewire and positioned across the lesion. Inflation of the balloon exerts radial force against the plaque, compressing it against the vessel wall and restoring luminal patency [3]. In addition to conventional balloon angioplasty, several advancements have enhanced the efficacy and safety of the procedure. Drug-Eluting Balloons (DEBs) and Drug- Eluting Stents (DESs) incorporate pharmacological agents, such as antiproliferative drugs, to mitigate neointimal hyperplasia and reduce rates of restenosis. Furthermore, the advent of intravascular imaging modalities, such as Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT), enables precise lesion assessment and optimized stent deployment [4].

Complications and considerations

Despite its widespread adoption, angioplasty is not without risks. Complications can arise during or after the procedure, ranging from access site complications, such as bleeding or pseudoaneurysm formation, to procedural complications, such as coronary dissection or thrombosis. Patient selection and meticulous procedural planning are paramount to minimizing these risks [5]. Factors such as lesion complexity, comorbidities, and operator experience influence procedural success and complication rates. In addition to acute complications, the long-term outcomes of angioplasty are influenced by restenosis, the re-narrowing of the treated vessel. Although the introduction of DESs has significantly reduced restenosis rates compared to Bare-Metal Stents (BMSs), it remains a concern, particularly in high-risk patients. Strategies to mitigate restenosis include optimal stent selection, adjunctive pharmacotherapy, and lifestyle modifications [6].

Recent years have witnessed remarkable advancements in angioplasty technology, driven by innovations in device design, imaging modalities, and procedural techniques. Bioresorbable scaffolds, for example, offer a temporary mechanical support to the vessel wall before gradually resorbing, potentially mitigating the longterm risks associated with permanent metallic stents [7-10]. Moreover, the emergence of robotic-assisted angioplasty and telemedicine platforms holds promise for improving procedural precision and expanding access to care, particularly in underserved regions. Furthermore, ongoing scientific work endeavors are exploring novel therapeutic targets and treatment modalities to address the underlying pathophysiology of CAD. From genetic therapies targeting lipid metabolism to cell-based therapies promoting vascular regeneration, the field of cardiovascular medicine is evolving rapidly, ushering in a new era of personalized and precision medicine.

Conclusion

In conclusion, angioplasty remains a cornerstone in the management of CAD and vascular occlusions, offering patients a minimally invasive alternative to traditional surgical revascularization. Through a comprehensive understanding of its techniques, complications, and recent advancements, clinicians can optimize patient outcomes and shape the future of cardiovascular medicine. As technology continues to evolve and our understanding of vascular biology deepens, the field of angioplasty will undoubtedly undergo further transformation, ushering in new paradigms in patient care and disease management.

References

1. Becker GJ, Katzen BT, Dake MD. (1989) Noncoronary angioplasty. Radiology 170(3):921-940.

   [Crossref][Google Scholar][PubMed]

2. Bittl JA. (1996) Advances in coronary angioplasty. N Engl J Med 335(17):1290-1302.

   [Crossref][Google Scholar][PubMed]

3. Castaneda-Zuniga WR, Formanek A, Tadavarthy M, Vlodaver Z, Edwards JE, et al. (1980)The mechanism of balloon angioplasty. Radiology 135(3):565-571.

   [Crossref][Google Scholar][PubMed]

4. Grines CL, Cox DA, Stone GW, Garcia E, Mattos LA,et al. (1999) Coronary angioplasty with or without stent implantation for acute myocardial infarction. N Engl J Med 341(26):1949-1956.

   [Crossref][Google Scholar][PubMed]

5. Faxon DP, Sanborn TA, Haudenschild CC. (1987) Mechanism of angioplasty and its relation to restenosis. Am J Cardiol 60(3):5-9.

   [Crossref][Google Scholar][PubMed]

6. Landau C, Lange RA, Hillis LD. (1994) Percutaneous transluminal coronary angioplasty. N Engl J Med 330(14):981-993.

   [Crossref][Google Scholar][PubMed]

7. Canto JG, Every NR, Magid DJ, Rogers WJ, Malmgren JA,et al. (2000) The volume of primary angioplasty procedures and survival after acute myocardial infarction. N Engl J Med 342(21):1573-1580.

   [Crossref][Google Scholar][PubMed]

8. Holmes Jr DR, Vlietstra RE, Reeder GS, Bresnahan JF, Smith HC, et al. (1984) Angioplasty in total coronary artery occlusion. Am J Cardiol 3(3):845-849.

   [Crossref][Google Scholar][PubMed]

9. O'Neill WW, Brodie BR, Ivanhoe R, Knopf W, Taylor G, et al. (1994)Primary coronary angioplasty for acute myocardial infarction (the Primary Angioplasty Registry). Am J Cardiol 73(9):627-633.

   [Crossref][Google Scholar][PubMed]

10. Kiemeneij F, Laarman GJ, de Melker E. (1995) Transradial artery coronary angioplasty. Am Heart J 129(1):1-7.

    [Crossref][Google Scholar][PubMed]