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My Child Has:
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Angioplasty
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Angioplasty is a therapeutic interventional radiologic technique in which a narrowed artery or vein is enlarged with the use of a balloon angioplasty catheter or a small metal stent (mesh tube).
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Children's Hospital Boston is equipped with state-of-the-art angiographic equipment and all of the necessary hemodynamic monitors, catheters and stents required for angioplasty of pediatric vessels. Because of the small and delicate nature of pediatric blood vessels, appropriate training and experience in these techniques and in the use of small catheters is important. The interventional radiology staff at Children's Hospital Boston is appropriately trained and experienced in these techniques. In addition, Children's Hospital Boston anesthesiology staff, radiology interventional technologists and nurses are appropriately trained and experienced in the care of children undergoing these procedures.
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Angioplasty is used as an alternative to surgical reconstruction in order to enlarge an abnormally narrowed blood vessel. The most common blood vessel diseases which cause symptoms in children are narrowing of the arteries to the kidneys, which may result in high blood pressure, and narrowing of central veins often related to the previous use of central venous catheters.
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Balloon and stent angioplasty are widely used techniques which have been proven safe and effective in treatment of blood vessel obstructions. However, as with all invasive procedures, complications and side effects may occur in a small percentage of patients. These will be explained to you in detail before you are asked to give consent for the procedure.
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You will be provided with written instructions at the time of scheduling the procedure. The patient must not eat any solid food for eight hours prior to the procedure, although the patient may drink clear liquids for up to three hours before to the procedure. The patient may also be asked to take additional medication or to not take usual medications the day prior to the procedure.
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The procedure starts with a standard angiogram. After the patient is given sedation medication or anesthesia, a catheter is inserted into the appropriate blood vessel, usually at the crease of the hip. Using the x-ray monitor to see the catheter, the interventional radiologist guides it into the blood vessel. Contrast medium is injected through the catheter and a series of x-ray images are obtained to outline the blood vessels. Once the abnormal narrowing has been identified and measured, the catheter is advanced across the narrowing and blood pressure measurements are recorded to determine the severity of the narrowing.
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The initial or diagnostic catheter is then exchanged for a catheter which has an inflatable balloon around its shaft. Again using the x-ray monitor and also using a special device to measure pressure in the balloon, the radiologist inflates the balloon. Contrast injection and pressure measurements are repeated to make sure that the narrowing is adequately widened. In some patients, the narrowing does not respond to simple balloon angioplasty. In this case, the balloon catheter can be inflated with a metallic stent (mesh tube) around it. Once the stent is expanded within the area of narrowing, it keeps the narrowed blood vessel open.
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After the desired result has been achieved, the radiologist removes the catheters and applies pressure to the catheter entry site to prevent bleeding. The patient is then transferred to the Recovery Room and is asked to keep the leg straight for 4 to 6 hours.
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The interventional radiologist is able to determine, from the angiographic images and the blood pressure measurements, whether or not a significant narrowing or blockage of the blood vessel is present. The angioplasty procedure stretches the blood vessel, which usually results in relief of the blockage.
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The interventional radiologist will speak with you at the end of the procedure and explain the findings and the results of the procedure.
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To obtain additional information before or after angioplasty, contact Children's Interventional Radiology Office at 617-355-6579. The appropriate person will be asked to return your call.
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