Page 1679 - Saunders Comprehensive Review For NCLEX-RN

positioned at the site of occlusion;
balloon inflation deploys the stent.
c. When placed in the coronary artery, the
stent reopens the blocked artery.
2. Preprocedure and postprocedure interventions
a. Care is similar to that for PTCA.

b. Acute thrombosis is a major

concern following the procedure; the
client is placed on antiplatelet therapy
such as clopidogrel and acetylsalicylic
acid (aspirin) for several months
following the procedure. Length of
time of antiplatelet therapy is
determined by the type of stent (metal
or medication-coated) that has been
deployed.
c. Monitor for complications of the
procedure such as stent migration or
occlusion, coronary artery dissection,
and bleeding resulting from
anticoagulation.
D. Atherectomy
1. Description
a. Atherectomy removes plaque from a
coronary artery by the use of a cutting
chamber on the inserted catheter or a
rotating blade that pulverizes the
plaque.
b. Atherectomy is also used to improve
blood flow to ischemic limbs in
individuals with peripheral arterial
disease.
2. Preprocedure and postprocedure interventions
a. Care is similar to that for PTCA.
b. Monitor for complications of
perforation, embolus, and reocclusion.
E. Transmyocardial revascularization
1. May be used for clients with widespread
atherosclerosis involving vessels that are too small
and numerous for replacement or balloon
catheterization; performed through a small chest
incision
2. Transmyocardial revascularization uses a high-
powered laser that creates 20 to 24 channels through
the ventricular muscle of the left ventricle; blood
enters these small channels, providing the affected
region of the heart with oxygenated blood.

1679