1. First stage.
The first part of the procedure is phlebography and/or arteriography with the use of contrast and 3D reconstructions.
The phlebography is based on a local puncture of a vein in the groin, followed by the administration of a contrasting agent, which enables the imaging of the venous system. In some cases it may be necessary to give the contrast through the artery.
The next step is real-time imaging of the vein interior. They are performed with the use of an endovascular ultrasound scanner. IVUS is an extremely precise tool enabling correct imaging of the inside of blood vessels. In practice, IVUS allows us to examine the actual structure of the vessel wall, as well as to obtain the image of the vein cross-section, thanks to which we can precisely select the type of balloon necessary for vessel dilatation during angioplasty procedure.
An important element of the IVUS test is the measurement of pressure gradients in the venous system. Pressure gradients influence the rate and directions of flower flow, and sudden pressure differences clearly indicate pathologies invisible with a standard camera.
2. Second stage.
The second part of the procedure is aimed at removing previously diagnosed deformities in the venous system. This procedure is performed with the use of the highest quality Philips angiograph system thanks to which we obtain the image in very good resolution. What is important, thanks to the synchronization of MRI images (resonance) with the angiograph (Virtual Road Map), the operator moves on previously outlined vessels, as a result of which the time of exposure to radiation and the amount of given contrast have been minimized.
A flexible catheter is introduced through a pre-punched place. Then, together with the balloon, it is moved to places of deformation specified at the earlier stage. The balloon is pumped to the appropriate pressure, thanks to which we widen the vessels to the desired size and at the same time restore proper blood circulation.
After the procedure, the catheter and the balloon are removed and the puncture site is secured.
3. After the procedure.
After the procedure, the catheter and balloon are removed and the puncture site is secured. The patient is transported to the postoperative room, and after another 2-3 hours to his room. The patient must be lying down for 6 hours from the end of the procedure.
The procedure lasts from 3 to 6 hours, depending on the complexity.