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 Basic Principles Underlying the Function of Endovascular Devices

Transluminal balloon angioplasty

  • Forces of transluminal vascular dilatation.
  • Mechanism of transluminal dilatation.
  • Characteristics of balloon construction (catheter pushability, trackability, crossability, balloon compliance).
  • Characteristics of catheter design.
  • Pathophysiology of the complications of transluminal dilation.

Endoluminal stents

  • Characteristics of balloon expandable stents.
  • Characteristics of self-expanding stents.
  • Coated stents.
  • Drug-eluting stents.
  • Parameters of proper stent deployment.
  • Complications of stent deployment.

Atherectomy

  • Characteristics of the Kensey catheter.
  • Characteristics of the Auth rotoblator.
  • Characteristics of the Simpson atherectomy catheter.
  • Characteristics of the transluminal extraction catheter.

Laser angioplasty

  • Laser physics.
  • Principles of dosimetry.
  • Characteristics of optical fibers.
  • Laser effects on target tissue (photothermal, photochemical, photoacoustic, nonlinear).
  • Specific laser systems (Nd:YAG laser, argon laser, excimer laser, CO2 laser).

Intravascular ultrasound

  • Basic properties of sound.
  • Instrumentation of intravascular ultrasound.
  • Practical application of ultrasound.

Angioscopy

  • Principles of light transmission.
  • The angioscopic system.

References

Moore WS, Ahn SS (eds). Endovascular surgery (3rd edition). Philadelphia : WS Saunders Co: 2001, pp 48-86, 149-171.

Basic principles underlying the function of endovascular devices are discussed in these sections, including guidewires, catheters and sheaths, balloon angioplasty, peripheral atherectomy, vascular stents, thrombectomy catheters, endovascular grafting, angioscopy and intravascular ultrasonography.

Haji-Aghaii M, Fogarty TJ. Balloon angioplasty, stenting, and role of atherectomy. Surg Clin North Am 1998;78:593-616.

An overview of endovascular interventions for the treatment of lower-extremity atherosclerotic disease is presented in this article. The indications, and results of balloon angioplasty, endoluminal stenting and transluminal atherectomy are discussed.

Ahn SS, Concepcion B. Current status of atherectomy for peripheral arterial occlusive disease. World J Surg 1996;20:635-643.

This article presents the unique features of four atherectomy devices: Simpson AtheroCath, Transluminal Extraction Catheter (TEC), Trac-Wright Catheter, and Auth Rotablator. The results, complications, and limitations reported by clinical investigators are discussed critically and realistically.

Nissen SE, Yock P. Intravascular ultrasound: novel pathophysiological insights and current clinical applications. Circulation 2001;103:604-616.

This review describes the rationale, technique, and interpretation of IVUS imaging in diagnostic and therapeutic applications. Special emphasis is placed on the impact of ultrasound in understanding atherosclerotic coronary disease and its management.

White JV, Eid I. Diagnostic and interventional angioscopy. Surg Clin North Am 1998;78:539-559.

The diagnostic and therapeutic applications (angioscopically guided luminal intervention) of angioscopy are reviewed in this article, including advantages, indications and technical considerations.

Posted June 2010