Talk:Angioplasty: Difference between revisions

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2020 and 31 January 2020. Further details are available on the course page. Student editor(s): Mrwikimed. Peer reviewers: ErBec.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 14:16, 16 January 2022 (UTC)

Early Comments

I am not a Cardiologist, so will not edit the page, however results of the following three tests demonstrate that Endarterectomy has superior short-term results versus Angioplasty. Refer to the MedScape CME at http://cme.medscape.com/viewarticle/718080. --tdschwarz (talk) 14:12, 9 March 2010 (UTC)

@tdschwarz, endarterectomy is not always an option in cases where angioplasty is chosen. In certain anatomic locations (like the common femoral artery, and maybe the internal carotid although thats a hot topic) endarterectomy has better outcomes. In others, like the superficial femoral artery, angioplasty or vascular bypass are used, since endarterectomizing the whole artery is not practical. BakerStMD T|C 19:50, 14 December 2014 (UTC)

Thanks for the Image, Bleiglass. Jfdwolff 19:22, 3 Mar 2004 (UTC)

A suggestion/request: Would it be possible to have a section on the page that summarises Angioplasty in 'lay' terms? I'm finding the article as it stands now a bit too complicated to follow, as it seems to make heavy use of specific terminology.

Above posted by User:217.169.18.208 on 14:18, 10 May 2006

Rewrite

I've just spent an hour trying to clean up this article. It is unreferenced, it was poorly written, and frankly, it reads like a Cordis or Guidant commercial. If one of their marketing people wrote this article, they ought to be terminated, because they don't know about what they speak. And if a Cardiologist wrote this article, remind me to ask to have his license checked. This article needs work. Orangemarlin 07:34, 5 March 2007 (UTC)

Percutaneous coronary intervention

I did some restructuring of the Coronary angioplasty section, hopefully to the better. But perhaps this section should be integrated in the percutaneous coronary intervention entry instead? Terjen 01:50, 6 March 2007 (UTC)

Thanks. This article is far from cleaned up. Let me read the other article and give my humble opinion. Orangemarlin 03:01, 6 March 2007 (UTC)

It needs a bit more work for sure.--Filll 20:28, 17 March 2007 (UTC)

Here's an interesting article about this topic

http://www.msnbc.msn.com/id/17800298/wid/11915773?GT1=9145

(article removed, since it was linked to above and is likely copyright vio)

Just a note, the study that the article refers to is a study on patients with stable angina only. The recommendations for these patients is to use drugs as first line therapy. Stenting is sometimes useful to relieve symptoms in those patients who don't get relief with drugs alone. Stenting is not used to prevent death or heart attack in this particular group of patients. So really the study that recently came out only reinforces current recommendations, I'm not sure why it's getting so much hype in the news and on wall street. Now, do patients get stents or procedures they don't need? Probably, but thats a different issue altogether.

Agree. First of all, if we are to refer to the trial, we should refer to the trial. Not a popular press piece that is made for sound bites. Second, if this goes anywhere, it should be in percutaneous coronary intervention (maybe in a section on indications for PCI?), not here. Ksheka 13:35, 20 May 2007 (UTC)

"Modified herpes virus keeps arteries 'free-flowing' following procedures"

“This study is an important step in the application of genetically engineered herpes simplex viruses for treatment of vascular disease," Skelly added. "It suggests that genetically engineered viruses may have a significant impact on the outcomes of angioplasty performed in humans. Human trials would be the next step to test this theory.” [1] Brian Pearson 03:54, 11 July 2007 (UTC)

Etymology

I've changed the word origin in the first paragraph (mainly because it is not a portmanteau word). I don't know how to do Greek characters (or if it's necessary), but if anybody would like to add the Greek script, aggeion has a circumflex accent on the "i" and plastos has an acute on the "o". DavidCh0 (talk) 12:42, 21 February 2008 (UTC)

The Greek script has been fixed.--Jmjanzen (talk) 13:50, 16 April 2008 (UTC)

Jmjanzen, you've added the diacritics to the Latin script, which is an improvement. I've added the words in Greek script - αγγειος needs a smooth breathing on tha alpha and a circumflex on the iota - can anybody help? (I managed the accent for plastos from the listed character set.) DavidCh0 (talk) 12:48, 14 July 2008 (UTC)

Balloon angioplasty

I entered 'balloon angioplasty' in the search bar and I was redirected to this page, which ostensibly tells me nothing about balloon angioplasty. Do all forms of angioplasty use balloons? How does balloon angioplasty work? This article doesn't help me at all. I'm going to research elsewhere and I may come back and add some clarifying material to the page for laypeople, but I invite anyone who already knows about balloon angioplasty to contribute instead, or in addition.--Jmjanzen (talk) 18:13, 11 April 2008 (UTC)

Yes, all angioplasty uses balloons. A good description can be found on the Percutaneous coronary intervention#Technique page. Perhaps some of the material can be moved to the angioplasty page. Dlodge (talk) 18:25, 11 April 2008 (UTC)

• Agree BakerStMD T|C 19:45, 14 December 2014 (UTC)

Yesterday, I ran across a reference to 'chemical angioplasty' in a scientific article, so I did a MEDLINE search for 'chemical angioplasty' and got 3 hits. It looks like some doctors are using this term to describe the intra-arterial injection of vasodilators to treat cerebral vasospasm. I think chemical/pharmacological angioplasty deserves mention in this article. When this is done, a redirect page should be created for 'chemical angioplasty'.--Jmjanzen (talk) 18:34, 17 April 2008 (UTC)

There is no such thing as chemical angioplasty - they are using the term in error when talking about invasive methods of injecting vasodilating drugs into the cerebral circulation. It is not a method of mechanically reshaping the vessel wall, it it using vasoactive drugs to affect the vessels innate smooth muscle. Dlodge (talk) 00:37, 19 April 2008 (UTC)

• Agree BakerStMD T|C 19:45, 14 December 2014 (UTC)

Study on angioplasty

People with chronic chest pain who are not in big danger of a heart attack now may have even less reason to rush into an artery-opening angioplasty: There's more evidence drugs should be tried first and often are just as effective. [2] —Preceding unsigned comment added by 99.224.46.255 (talk) 21:59, 13 August 2008 (UTC)

External Links

The first link is misleading. The text of the link states that a PTCA procedure is on video, and it turns out to be a double bypass. I reccomend that the text be changed or the link be removed. I am referring to the text "A BBC film showing angioplasty being used for primary percutaneous intervention" with the link: http://www.bbc.co.uk/tees/content/articles/2008/11/21/jeffrey_bypass_feature.shtml Atrawick (talk) 19:51, 24 February 2009 (UTC)Atrawick

History Section is Inaccurate

It is well known that angioplasty was initially described by interventional radiologist Charles Dotter in 1964.

Dotter, C.T. and M.P. Judkins. Transluminal treatment of arteriosclerotic obstruction. Circulation. Volume 30. Pages 654-670. http://circ.ahajournals.org/cgi/reprint/30/5/654

I think that the history section should be moved to directly after the introduction and should accurately depict Dr. Dotter as the inventor of the procedure. —Preceding unsigned comment added by 207.64.141.9 (talk) 21:10, 6 December 2010 (UTC)

Merger Proposal

I would like to propose that this article be merged with Percutaneous coronary intervention -- and while i have proposed this on the PCI page, I am still unsure which should be merged where. This article seems to be in need of cleanup, and the PCI article at least seems to be more frequently edited. The complication is that Angioplasty has MeSH terms for it specifically, though it appears in some way to be a subset of PCI. The literature seems to refer to PCI more than angioplasty, at least recently. Either way, it seems worthy to discuss the merging of the two articles. UseTheCommandLine (talk) 22:35, 26 August 2012 (UTC)

• Disagree. Angioplasty not just used in the heart. Thus it should not be merged with a page that only discussed the use of the technique only in the heart. BakerStMD T|C 19:44, 14 December 2014 (UTC)

"Patient Safety" section is misplaced

This section doesn't appear to bear specifically to angioplasty, it sounds biased, and doesn't appear well-referenced.

I recommend removing it entirely, but it should minimally be reduced in scope to something that pertains more directly with angioplasty and perhaps the (higher?) risks associated with patient safety in this procedure. — Preceding unsigned comment added by 208.8.94.126 (talk) 15:54, 29 April 2014 (UTC)

Identical content was cross-posted into several medical articles. I agree it is out of place and potentially biased; could be some sort of SEO attempt or something. I've removed it from all the pages I found it on, with the exception of Patient safety where it may, arguably, have a place. - Eron^Talk 17:03, 29 April 2014 (UTC)

WP:MEDMOS

I just reorganized this article to follow WP:Medmos. The outline proposed there for operations and procedures is:

• Medical uses
• Contra-indications
• Technique (avoid step-by-step instructions)
• Risks/Complications
• Recovery or Rehabilitation
• History (e.g., when it was invented)
• Society and culture (includes legal issues, if any)
• Special populations
• Other animals

BakerStMD T|C 20:23, 13 January 2015 (UTC)

sizes - (spatial dimensions = lengths, thicknesses), numbers

   This article is of some academic interest to students and others either for pre-medical preparation or for a better understanding and handling of the reader's personal world (with its people and other creatures).

  The pictures of medical, anatomical entities, for a better appreciation of their importance in maintaining good health, may include a depiction of physical dimensions while in the human.  — Preceding unsigned comment added by Vijay Chary (talk • contribs) 23:52, 25 April 2016 (UTC) 

External links modified

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Workplan to edit and add to this page

These are several additions and edits I would like to add to the angioplasty article:

Uses section:

Peripheral angioplasty: Systematic review finds that among patients with femoropopliteal arterial occlusive disease, drug-eluting balloon angioplasty had significantly less restenosis, late lumen loss and target lesion revascularization at both short term and midterms follow-up compared to uncoated balloon angioplasty. Reference: PMID: 27478005

Renal Artery Angioplasty: Systematic review suggests there is a weak recommendation for renal artery angioplasty in patients with renal artery stenosis and flash edema or congestive heart failure. Reference: PMID: 22455866

Venous angioplasty: Systematic review suggests there is a weak recommendation for deep venous stenting to treat obstructive chronic venous disease. Reference: PMID: 26464055

Risks and Complications section:

Systematic review of patients with Aortoiliac Occlusive Disease (AIOD) identifies distal embolization, access site hematomas, pseudoaneurysms, arterial ruptures and arterial dissections as potential adverse outcomes of angioplasty. Reference: PMID: 20598474

I want to add:

Cerebral Hyperperfusion Syndrome leading to stroke is a serious complication of carotid artery angioplasty with stenting. Reference: PMID: 30196814

Recovery section:

I want to add:

A systematic review finds concomitant use of Clopidogrel and Proton Pump Inhibitors following coronary angiography is associated with significantly higher adverse cardiovascular complications such as MACEs, stent thrombosis and myocardial infarction. Long-term mortality is not significantly different, though. Reference: PMID: 28056809

References section: Remove reference 5 which links to unrelated breast imaging page. — Preceding unsigned comment added by Mrwikimed (talk • contribs) 19:56, 9 January 2020 (UTC)

Moved from PCI section of this article

A PCI used with stable coronary artery disease reduces chest pain but does not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy. This finding has be en further confirmed by the $100 million 2019 ISCHEMIA Trial.

Furthermore, mortality rates are higher after PCI compared to Coronary artery bypass grafting in patients with multivessel disease especially with comorbid conditions such as diabetes.

References

WikiProject Medicine Peer Review

Here is some comments by particular topics. Overall looks really good.

Target Audience readability: I think this topic is a difficult one for the general population to fully understand. I think you did well explaining it to the target audience (Probably mostly non-physicians). I like how many of the harder to understand words are linked to fully understand them. Some sentences may be hard for the general population to understand. For example “late lumen loss and target lesion revascularization”, but there really isn't that many ways to reword it without sounding like a run-on sentence. Overall really good on a topic that is hard.

Citations: Look mostly solid. Links work to most, number 3,26, and 31 aren’t working. 28 and 29 aren’t particularly reliable.

Workplan: Definitely completed goal and much more than what is on workplan.

Media: I think these are good. Somewhat repetitive between 1st image and 4th image, but show a clear picture of what is happening.

Structure/Content: Good flow, no run-on sentences. Could add who performs these procedures and talk about age. Additionally, you speak about it more in certain categories and mention that it is for atherosclerotic disease, but you could mention the symptoms that it helps. For example you mention for PAD and could talk about relieving some claudication, or CAD and SOB/CP. Really clear on complications which I think most people viewing the page would be looking at.

Neutrality: Looks neutral

Again, well done. I can tell a lot of effort was put into editing it.

ErBec (talk) 21:15, 28 January 2020 (UTC)