Angioplasty and Stenting in Dialysis
In the angioplasty procedure, imaging techniques are used to guide a balloon-tipped catheter, a long, thin plastic tube, into an artery or vein and advance it to where the vessel is narrow or blocked. The balloon is inflated to open the vessel, then deflated and removed.
A balloon catheter is a long, thin plastic tube with a tiny balloon at its tip. A stent is a small, wire mesh tube. Balloons and stents come in varying sizes to match the size of the diseased artery.
In vascular stenting, which may be performed with angioplasty, a small wire mesh tube, called a stent, is permanently placed in the newly opened artery or vein to help it remain open. There are two types of stents: bare stents (wire mesh) and covered stents (also commonly called stent grafts).
Stents are specially designed mesh, metal tubes that are inserted into the body in a collapsed state on a catheter and then expanded inside the vessel to prop the walls open. In some cases the stent may have a synthetic fabric covering.
Angioplasty and angioplasty with vascular stenting are commonly used to treat conditions that involve a narrowing or blockage of arteries or veins throughout the body, including:
Renal Vascular Hypertension
Renal Vascular Hypertension is high blood pressure caused by a narrowing of the kidney arteries. Angioplasty with stenting is a commonly used method to open one or both of the arteries that supply blood to the kidneys. Treating renal arterial narrowing is also performed in some patients to protect or improve the renal function.
Narrowing in Dialysis Fistula or Grafts
It is very common to see narrowing involving the dialysis fistula or graft. When there is decreased flow in the graft or fistula that is not adequate for dialysis, angioplasty is generally the first line of treatment. Stenting or stent-grafting may also be needed in some cases.
In these procedures, x-ray imaging equipment, a balloon catheter, sheath, stent, and guide wire are used.
The equipment typically used for this examination consists of a radiographic table, an x-ray tube and a television-like monitor that is located in the examining room or in a nearby room. A guide wire is a thin wire used to guide the placement of the diagnostic catheter, angioplasty balloon catheter, and the vascular stent. A sheath is a vascular tube placed into the access artery, such as the femoral artery in the groin, which allows catheter exchanges easily during these complex procedures.
This procedure is often done on an outpatient basis.
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