Thoracic Key

4.1 Choosing access site Obtaining arterial access is required for performing diagnostic coronary angiography and percutaneous coronary intervention (PCI). There is continued controversy about optimal access site selection. Radial (proximal…

In Chapter 4 , Access, we discussed about how to obtain arterial access. In this chapter we describe the steps involved in advancing a catheter over a guidewire from the…

Goal : To advance a guidewire through and distal to the target coronary lesion in the most efficient way and without causing a complication and to provide an adequate platform…

Although adjunctive modalities (stress testing, noninvasive imaging including coronary computed angiography, coronary physiology, and intracoronary imaging) can help evaluate coronary anatomy, coronary angiography remains the most commonly used technique for…

The following decisions need to be made after coronary angiography is performed. 1. Is coronary revascularization needed? Like every other procedure, coronary revascularization should be done when the anticipated benefits…

In this chapter we discuss the following classes of medications that are commonly used in the cardiac catheterization laboratory: 1. Sedatives and analgesics 2. Vasodilators 3. Contrast media 4. Anticoagulants…

If you fail to plan you are planning to fail. Benjamin Franklin. Planning is essential for every procedure, including percutaneous coronary intervention (PCI). Thoughtful planning and appropriate preparation before performing…

Monitoring the patient should be continually performed from the beginning to the end of the case, so that potential complications are promptly identified and corrected. The following parameters are assessed…