Endovascular treatments are a type of minimally invasive procedure performed inside the blood vessels using precision catheters for diagnostics and intervention. Common applications include cardiology, neurology and peripheral vascular. A wide range of interventional procedures take advantage of the entire Dunn precision tubing product line, with exceptionally small diameters, thin walls and tight tolerances.
Coronary Angiography and Angioplasty
Cardiac catheterization involves examination and interventional procedures of the heart. Coronary angiography uses catheters inserted into a femoral or radial artery to access the heart and inject dye for fluoroscopic examination of arterial blockage, valve performance and more. Coronary angioplasty uses similarly inserted catheters to deploy balloon catheters to open blocked arteries. Often, these balloons deploy stents to ensure the blocked artery remains open.
Transcatheter Valve Replacement
Catheters can also be used to deploy valves in the heart. These include the aortic and mitral valves. For transcatheter aortic valve replacement (TAVR), a catheter is inserted into the femoral artery to access the heart. From the catheter, a new aortic valve is deployed without removing the old valve. Conceptually, this is similar to the deployment of a stent placed in an artery, and avoids the risks of open heart surgery for many patients.
Electrophysiology studies (EPS) are used to evaluate electrical activity of the heart. Abnormal heart rhythms are known as arrhythmias. These studies are performed with peripherally inserted catheters to access the inside of the heart. Electrodes placed on the distal tip of these catheters are used to monitor electrical current. Arrythmias may be treated by destroying the place inside the heart that is causing abnormal electrical current, a procedure known as catheter ablation; applying predictable current using a pacemaker, of which some can be deployed inside the heart via catheters; or by implanted defibrillators.
Similar procedures to treat coronary artery disease (a narrowing of the arteries that carry blood and oxygen to the heart muscle) are used in a variety of other endovascular applications. These include:
- Peripheral artery disease (PAD) – narrowing of the arteries of legs or arms
- Cartoid artery stenosis – narrowing of the neck arteries supplying blood to the brain
- Renal vascular hypertension – high blood pressure caused by narrowing of the kidney arteries
- Chest, abdomen and pelvis arterial narrowing
- Narrowing of fistulas or grafts used for dialysis
These minimally invasive catheter technology to diagnose and treat complex cerebrovascular disorders, such as stroke, vascular disease, aneurysms and other complex neurological conditions.
During endovascular embolization, the neurosurgeon inserts a catheter into the femoral artery and navigates through the vascular system to the aneurysm. Once the catheter is in place, the doctor places small plastic particles, glue, metal coils, foam, or a balloon through it to seal off the faulty blood vessel. These embolizing agents block blood flow to the aneurysm, preventing rupture while promoting blood clotting (thrombosis).
Carotid angioplasty and stenting are procedures that open clogged arteries to restore blood flow to the brain. These procedures are often performed to treat or prevent stroke. The carotid arteries are located on each side of the neck and supply blood to the brain. Carotid angioplasty and stenting may be used when traditional carotid surgery isn’t possible, or is too risky.
Thrombectomy is the interventional procedure of removing a blood clot (thrombus) from a blood vessel. Special catheters can be used to remove thrombus using suction, physical extraction using snares or baskets, or other mechanisms designed to break up thrombus such as saline jets or ultrasound waves.