The term duplex refers to 2 modes of ultrasound scanning being conducted. The B-mode transducer allows for an image of the vessel to be obtained, providing visual cues on the extent of occlusion. Meanwhile, the doppler probe is used to acquire data on velocity and direction of blood flow. Multi-Detector Coronary Tomography (MDCT) Angiography
Traditionally, angiography is an invasive technique which involves inserting a flexible plastic catheter into the artery of interest. A radioactive contrast dye is then injected through the catheter and viewed on an X-ray. This contrast material does not permanently discolor any organs, but simply interacts with X-rays to produce a more precise diagnosis.Due to technological advances, clinicians have begun to use a less invasive approach called Multi-Detector Coronary Tomography (MDCT) angiography. Rather than inserting a large catheter into the artery, this technique requires a small injection of contrast dye using a standard intravenous catheter inserted into the arm, much like a regular injection. MDCT scanners then locate the contrast dye to show blockages within the arteries. MDCT angiography is more sensitive in detecting blockage and subsequent diseases such as CAD compared to invasive X-ray angiography. Treatment
Treatment for arterial occlusion varies depending on the extent of blockage. In severe cases, surgical intervention is needed to remove the blockage from the affected artery. Currently, there are 3 types of surgical approaches, including surgical bypass, endarterectomy, and embolectomy. If surgery is not required, blood-thinning medication may be prescribed. Surgical Bypass
A surgical bypass is a procedure performed to treat CAD.
This procedure involves bypassing the blocked portion of the artery by replacing it with a healthy vessel from elsewhere in the body. The surgeon attaches one end of the new vessel right before the blockage, and the other end in the area after the affected portion. This reestablishes proper blood flow toward the desired area. Endarterectomy
An endarterectomy is an intervention aiming to remove accumulated plaques directly from the affected artery. This involves an incision on the side of the neck of the affected artery. The plaque is then exposed and removed accordingly, with the artery then stitched back together. With the plaque removed, blood can travel through the artery unimpeded. Embolectomy
An embolectomy is a procedure conducted when a blockage moves from its original site to another place in the body, thus forming an embolus. There are two methods of performing embolectomy. The first method is catheter embolectomy, which involves the insertion of a catheter into the affected artery and the subsequent removal of the embolus. This option is minimally invasive, and thus lowers risk and recovery time. The other option is a traditional surgical option, where the surgeon will expose the affected region, open the blood vessel and remove the embolus. Blood-thinning Medication
Blood-thinning medications are beneficial short-term options in managing arterial occlusion. Anticoagulants such as warfarin and antiplatelets such as aspirin and clopidogrel reduce the risk of thrombosis by making blood flow easily through arteries. Side effects include increased bleeding and heavier bruising. == References ==