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Dr. Qazi and Dr. Eres are on the cutting edge of innovative technology to diagnose and treat coronary and peripheral vascular disease. They have each performed over 30,000 cardiac procedures. Some of the invasive procedures they perform are as follows:
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Cardiac Procedures - Diagnostic and Interventional
Cardiac Catheterization
This is a procedure to examine blood flow to the heart and test how well the heart is pumping. A doctor inserts a thin plastic tube (catheter) into an artery or vein in the arm or leg. From there it can be advanced into the chambers of the heart or into the coronary arteries. This test can measure blood pressure within the heart and how much oxygen is in the blood. It's also used to get information about the pumping ability of the heart muscle. Catheters are also used to inject dye into the coronary arteries. This is called coronary angiography (an"je-OG'rah-fe). For more comprehensive information, please see booklet Understanding Cardiac Catheterization or a 10 minute video on Cardiac Catheterization (Tab Patient Education/Link Booklets and Videos/Select Title).
Stenting and Angioplasty
A stent is a small metal mesh tube that acts as a scaffold to provide support inside your coronary artery. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed coronary artery. Once in place, the balloon tip is inflated and the stent expands to the size of the artery and holds it open. The balloon is then deflated and removed while the stent stays in place permanently. Over a several-week period, your artery heals around the stent. Stents are commonly placed during interventional procedures such as angioplasty to help keep the coronary artery open. Some stents contain medicine and are designed to reduce the risk of reblockage (restenosis). The doctor will determine if this type of stent is appropriate for your type of blockage. For more information, please see our booklet Understanding Angioplasty and Stenting (Tab Patient Education/Link Booklets and Videos/Select Title).
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Intravascular Ultrasound
A tiny ultrasound wand is attached to the top of a tiny, hollow tube called a catheter. This ultrasound catheter is inserted into an artery in your groin area and moved up to the heart. A computer measures how the sound waves reflect off blood vessels, and changes the sound waves into pictures. IVUS gives the cardiologist a look at your coronary arteries from the inside-out. IVUS is almost always done at the end of angioplasty with stent placement, or coronary catheterization. Angioplasty gives a general look at the coronary arteries, but it cannot show the walls of the arteries. IVUS images show the artery walls and can reveal cholesterol and fat deposits (plaques). Buildup of these deposits can increase your risk of a heart attack. IVUS has provided a lot of insight into how stents become clogged (stent restenosis).
Fractional Flow Reserve
Fractional Flow Reserve, or FFR, is a guide wire-based procedure that can accurately measure blood pressure and flow through a specific part of the coronary artery. FFR is done through a standard diagnostic catheter at the time of a coronary angiogram. The measurement of Fractional Flow Reserve has been shown useful in assessing whether or not to perform angioplasty or stenting on "intermediate" blockages. The point of opening up narrowings or blockages in the coronary arteries is to increase blood flow to the heart. But a number of studies have shown that if a "functional measurement", such as Fractional Flow Reserve, shows that the flow is not significantly obstructed, the blockage or lesion does not need to be revascularized (angioplasty) and the patient can be treated safely with medical therapy.
TOP
Peripheral Vascular Procedures - Diagnostic and Interventional
Carotid Angiograms
An angiogram of the neck (carotid angiogram) can be used to look at the large arteries in the neck that lead to the brain. An angiogram of the head (cerebral angiogram) can be used to look at the veins or the four arteries (four-vessel study) carrying blood to the brain. During an angiogram, a thin, soft tube called a catheter is placed into a blood vessel in the groin (femoral artery or vein) or just above the elbow (brachial artery or vein). Please see booklet Carotid Angiography or a 10 minute video on Carotid Artery Disease (Tab Patient Education/Link Booklets and Videos/Select Title).
Peripheral Angiography (Upper and Lower Extremities)
Peripheral angiography is an outpatient diagnostic study for patients who may have blocked blood vessels in their legs and lower body. Utilizing a dye that is injected to make arteries visible when mixed with blood, doctors can have a "map" of a patient's blood vessels to determine if there's disease or blockage and where the problem is located. In the short term, blocked arteries can lead to leg cramps and can deter wounds in the lower extremities from healing properly. In the long term, the condition can set the stage for high blood pressure or stroke. A peripheral angiogram may also be used to detect potential blood-flow problems in the upper body and in the abdominal area. For more information, please see booklet Peripheral Angiography or a 10 minute video on Peripheral Arterial Disease (Tab Patient Education/Link Booklets and Videos/Select Title).
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Peripheral Angioplasty and Stenting
In an angioplasty, your cardiologist inflates a small balloon inside a narrowed blood vessel. The balloon helps to widen your blood vessel and restore normal blood flow. After widening the vessel with angioplasty, your cardiologist sometimes inserts a stent depending upon the circumstances. Stents are tiny mesh tubes that support your artery walls to keep your vessels wide open. Angioplasty and stenting are usually done through a small incision or puncture in your skin, called the access site. Your cardiologist inserts a long, thin tube called a catheter through this access site. Your cardiologist guides the catheter through your blood vessels to the blocked area. The tip of the catheter carries the angioplasty balloon or stent. For more information, please see booklet Angioplasty and Stenting for PAD (Tab Patient Education/Link Booklets and Videos/Select Title).
Peripheral Atherectomy
Peripheral arterial atherectomy, is a procedure in which a catheter with a rotating blade is used to destroy a stenosis or complete occlusion within the lower extremity arteries. The Diamondback 360°is an atherectomy device that uses a tiny, rotating diamond-coated "crown" inserted into the artery that gently sands away tough plaque and restores blood flow. The minimally invasive procedure offers new hope to patients, as it provides an effective alternative for surgery or amputation.
TOP
Angiojet Thrombolysis for DVT
Angiojet thrombectomy is a catheter-based procedure used for thrombolysis. "Thrombus" is a blood clot; "lysis" means to break apart. So, angiojet thrombectomy is used to break up a blood clot that is causing partial or full obstruction of blood flow in an artery. Angiojet thrombectomy is often used prior to angioplasty with or without stent placement, to remove dangerous blood clots, making the angioplasty procedure safer and more effective.
The angiojet is a tiny device attached to a catheter that is inserted into an artery in the groin (the femoral artery). The catheter (with angiojet attached) is advanced to the peripheral artery containing the blood clot. Once properly positioned, the pump of the angiojet is activated, delivering a saline solution under high pressure out thru the pump jets, into the artery, and directly at the blood clot. These saline jets create a powerful vacuum within the artery, breaking up the clot, and removing clot pieces out thru the catheter and into the pump. The catheter with angiojet device is removed, pressure is applied to stop bleeding, and the patient must rest flat for several hours. For more information, see booklet Thrombolysis for DVT (Tab Patient Education/Link Booklets and Videos/Select Title).
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Peripheral IVUS
A tiny ultrasound wand is attached to the top of a tiny, hollow tube called a catheter. This ultrasound catheter is inserted into an artery in your groin area and moved to the arteries in your lower or upper extremities. A computer measures how the sound waves reflect off blood vessels, and changes the sound waves into pictures. IVUS gives the cardiologist a look at your extremity arteries from the inside-out. IVUS is almost always done at the end of angioplasty with stent placement, or coronary catheterization. IVUS images show the artery walls and can reveal cholesterol and fat deposits (plaques). Buildup of these deposits can increase your risk of a heart attack. IVUS has provided a lot of insight into how stents become clogged (stent restenosis).
Abdominal Aortogram
This procedure finds areas in your blood vessels where they are narrowing or closing. An aortogram may also be used to evaluate an abdominal aneurysm. Your Cardiologist will thread a narrow, flexible plastic tube, called a catheter, through the arteries suspected of having the narrowing or blockage. The tube will be hooked to a pump that injects X-ray dye. Once the X-ray pictures show where the blockages are, your doctor will be able to tell the best way to open the blocked blood vessels. This should stop the pain and reduce the risk of blood clots.
TOP
Pulmonary Angiography
An angiogram is an x-ray of your blood vessels that shows blockages or other abnormalities in veins or arteries. It uses a contrast dye, a liquid that helps blood vessels show up clearly on x-rays. The dye is injected into the body and its movement is tracked by a series of x-rays. Most often a pulmonary angiogram is performed to see whether a pulmonary embolus, or blood clot, has traveled through the veins from the legs or pelvis into the lungs, blocking blood flow to a part of your lungs. Using live x-rays displayed on a video monitor as a guide, your cardiologist moves the catheter along the vein until it reaches your vena cava (the large blood vessel that carries blood to your heart from the rest of your body), then into the right side of your heart and finally into the pulmonary arteries that carry blood from the heart to your lungs. When the tip of the catheter is pointed into the pulmonary arteries, the cardiologist injects contrast dye, illuminating the arteries on an x-ray. If there is a blood clot in the lung arteries, it will show up on the x-ray.
IVC Filter or Inferior Vena Cava Filter
In an inferior vena cava filter placement procedure, your interventional cardiologist uses image guidance to place a filter in the inferior vena cava (IVC), the large vein in the abdomen that returns blood from the lower body to the heart. Blood clots that develop in the veins of the leg or pelvis, a condition called deep vein thrombosis (DVT), occasionally break up and large pieces of the clot can travel to the lungs. An IVC filter traps large clot fragments and prevents them from traveling through the vena cava vein to the heart and lungs, where they could cause severe complications or even death. For More information, please refer to booklet IVC filter for DVT (Tab Patient Education/Link Booklets and Videos/Select Title).
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Renal Angiography
Renal angiography (x-ray of the arteries supplying blood to the kidneys) is performed for patients with elevated blood pressure or impaired kidney function suspected of being due to blockage of the arteries supplying the kidneys. Patients with elevated blood pressure due to blockage of the arteries are candidates for angioplasty (repair of the artery using a balloon) if they are on 3 or more blood pressure medications or have intolerable side effects of fewer medications. In addition all patients with impaired renal function and blockage of both renal arteries are candidates for angioplasty.
Renal Angioplasty and Stenting
Narrowing or blockage of the renal artery (the main blood vessel that supplies the kidneys) can cause severely high blood pressure or problems with kidney function. Angioplasty is a procedure that uses a small balloon to widen the passage through a blood vessel. A stent is a small metal mesh tube put into a blood vessel to help hold it open. Renal angioplasty and stenting can help improve blood flow to the kidney and relieve problems. For more information, see a 6 minute video about Renal Artery Stenosis (Tab Patient Education/Link Booklets and Videos/Select Title).
TOP
Top of Page
Dr. Qazi and Dr. Eres are on the cutting edge of innovative technology to diagnose and treat coronary and peripheral vascular disease. They have each performed over 30,000 cardiac procedures. Some of the invasive procedures they perform are as follows:
TOP
Cardiac Procedures - Diagnostic and Interventional
Cardiac Catheterization
This is a procedure to examine blood flow to the heart and test how well the heart is pumping. A doctor inserts a thin plastic tube (catheter) into an artery or vein in the arm or leg. From there it can be advanced into the chambers of the heart or into the coronary arteries. This test can measure blood pressure within the heart and how much oxygen is in the blood. It's also used to get information about the pumping ability of the heart muscle. Catheters are also used to inject dye into the coronary arteries. This is called coronary angiography (an"je-OG'rah-fe). For more comprehensive information, please see booklet Understanding Cardiac Catheterization or a 10 minute video on Cardiac Catheterization (Tab Patient Education/Link Booklets and Videos/Select Title).
Stenting and Angioplasty
A stent is a small metal mesh tube that acts as a scaffold to provide support inside your coronary artery. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed coronary artery. Once in place, the balloon tip is inflated and the stent expands to the size of the artery and holds it open. The balloon is then deflated and removed while the stent stays in place permanently. Over a several-week period, your artery heals around the stent. Stents are commonly placed during interventional procedures such as angioplasty to help keep the coronary artery open. Some stents contain medicine and are designed to reduce the risk of reblockage (restenosis). The doctor will determine if this type of stent is appropriate for your type of blockage. For more information, please see our booklet Understanding Angioplasty and Stenting (Tab Patient Education/Link Booklets and Videos/Select Title).
TOP
Intravascular Ultrasound
A tiny ultrasound wand is attached to the top of a tiny, hollow tube called a catheter. This ultrasound catheter is inserted into an artery in your groin area and moved up to the heart. A computer measures how the sound waves reflect off blood vessels, and changes the sound waves into pictures. IVUS gives the cardiologist a look at your coronary arteries from the inside-out. IVUS is almost always done at the end of angioplasty with stent placement, or coronary catheterization. Angioplasty gives a general look at the coronary arteries, but it cannot show the walls of the arteries. IVUS images show the artery walls and can reveal cholesterol and fat deposits (plaques). Buildup of these deposits can increase your risk of a heart attack. IVUS has provided a lot of insight into how stents become clogged (stent restenosis).
Fractional Flow Reserve
Fractional Flow Reserve, or FFR, is a guide wire-based procedure that can accurately measure blood pressure and flow through a specific part of the coronary artery. FFR is done through a standard diagnostic catheter at the time of a coronary angiogram. The measurement of Fractional Flow Reserve has been shown useful in assessing whether or not to perform angioplasty or stenting on "intermediate" blockages. The point of opening up narrowings or blockages in the coronary arteries is to increase blood flow to the heart. But a number of studies have shown that if a "functional measurement", such as Fractional Flow Reserve, shows that the flow is not significantly obstructed, the blockage or lesion does not need to be revascularized (angioplasty) and the patient can be treated safely with medical therapy.
TOP
Peripheral Vascular Procedures - Diagnostic and Interventional
Carotid Angiograms
An angiogram of the neck (carotid angiogram) can be used to look at the large arteries in the neck that lead to the brain. An angiogram of the head (cerebral angiogram) can be used to look at the veins or the four arteries (four-vessel study) carrying blood to the brain. During an angiogram, a thin, soft tube called a catheter is placed into a blood vessel in the groin (femoral artery or vein) or just above the elbow (brachial artery or vein). Please see booklet Carotid Angiography or a 10 minute video on Carotid Artery Disease (Tab Patient Education/Link Booklets and Videos/Select Title).
Peripheral Angiography (Upper and Lower Extremities)
Peripheral angiography is an outpatient diagnostic study for patients who may have blocked blood vessels in their legs and lower body. Utilizing a dye that is injected to make arteries visible when mixed with blood, doctors can have a "map" of a patient's blood vessels to determine if there's disease or blockage and where the problem is located. In the short term, blocked arteries can lead to leg cramps and can deter wounds in the lower extremities from healing properly. In the long term, the condition can set the stage for high blood pressure or stroke. A peripheral angiogram may also be used to detect potential blood-flow problems in the upper body and in the abdominal area. For more information, please see booklet Peripheral Angiography or a 10 minute video on Peripheral Arterial Disease (Tab Patient Education/Link Booklets and Videos/Select Title).
TOP
Peripheral Angioplasty and Stenting
In an angioplasty, your cardiologist inflates a small balloon inside a narrowed blood vessel. The balloon helps to widen your blood vessel and restore normal blood flow. After widening the vessel with angioplasty, your cardiologist sometimes inserts a stent depending upon the circumstances. Stents are tiny mesh tubes that support your artery walls to keep your vessels wide open. Angioplasty and stenting are usually done through a small incision or puncture in your skin, called the access site. Your cardiologist inserts a long, thin tube called a catheter through this access site. Your cardiologist guides the catheter through your blood vessels to the blocked area. The tip of the catheter carries the angioplasty balloon or stent. For more information, please see booklet Angioplasty and Stenting for PAD (Tab Patient Education/Link Booklets and Videos/Select Title).
Peripheral Atherectomy
Peripheral arterial atherectomy, is a procedure in which a catheter with a rotating blade is used to destroy a stenosis or complete occlusion within the lower extremity arteries. The Diamondback 360°is an atherectomy device that uses a tiny, rotating diamond-coated "crown" inserted into the artery that gently sands away tough plaque and restores blood flow. The minimally invasive procedure offers new hope to patients, as it provides an effective alternative for surgery or amputation.
TOP
Angiojet Thrombolysis for DVT
Angiojet thrombectomy is a catheter-based procedure used for thrombolysis. "Thrombus" is a blood clot; "lysis" means to break apart. So, angiojet thrombectomy is used to break up a blood clot that is causing partial or full obstruction of blood flow in an artery. Angiojet thrombectomy is often used prior to angioplasty with or without stent placement, to remove dangerous blood clots, making the angioplasty procedure safer and more effective.
The angiojet is a tiny device attached to a catheter that is inserted into an artery in the groin (the femoral artery). The catheter (with angiojet attached) is advanced to the peripheral artery containing the blood clot. Once properly positioned, the pump of the angiojet is activated, delivering a saline solution under high pressure out thru the pump jets, into the artery, and directly at the blood clot. These saline jets create a powerful vacuum within the artery, breaking up the clot, and removing clot pieces out thru the catheter and into the pump. The catheter with angiojet device is removed, pressure is applied to stop bleeding, and the patient must rest flat for several hours. For more information, see booklet Thrombolysis for DVT (Tab Patient Education/Link Booklets and Videos/Select Title).
TOP
Peripheral IVUS
A tiny ultrasound wand is attached to the top of a tiny, hollow tube called a catheter. This ultrasound catheter is inserted into an artery in your groin area and moved to the arteries in your lower or upper extremities. A computer measures how the sound waves reflect off blood vessels, and changes the sound waves into pictures. IVUS gives the cardiologist a look at your extremity arteries from the inside-out. IVUS is almost always done at the end of angioplasty with stent placement, or coronary catheterization. IVUS images show the artery walls and can reveal cholesterol and fat deposits (plaques). Buildup of these deposits can increase your risk of a heart attack. IVUS has provided a lot of insight into how stents become clogged (stent restenosis).
Abdominal Aortogram
This procedure finds areas in your blood vessels where they are narrowing or closing. An aortogram may also be used to evaluate an abdominal aneurysm. Your Cardiologist will thread a narrow, flexible plastic tube, called a catheter, through the arteries suspected of having the narrowing or blockage. The tube will be hooked to a pump that injects X-ray dye. Once the X-ray pictures show where the blockages are, your doctor will be able to tell the best way to open the blocked blood vessels. This should stop the pain and reduce the risk of blood clots.
TOP
Pulmonary Angiography
An angiogram is an x-ray of your blood vessels that shows blockages or other abnormalities in veins or arteries. It uses a contrast dye, a liquid that helps blood vessels show up clearly on x-rays. The dye is injected into the body and its movement is tracked by a series of x-rays. Most often a pulmonary angiogram is performed to see whether a pulmonary embolus, or blood clot, has traveled through the veins from the legs or pelvis into the lungs, blocking blood flow to a part of your lungs. Using live x-rays displayed on a video monitor as a guide, your cardiologist moves the catheter along the vein until it reaches your vena cava (the large blood vessel that carries blood to your heart from the rest of your body), then into the right side of your heart and finally into the pulmonary arteries that carry blood from the heart to your lungs. When the tip of the catheter is pointed into the pulmonary arteries, the cardiologist injects contrast dye, illuminating the arteries on an x-ray. If there is a blood clot in the lung arteries, it will show up on the x-ray.
IVC Filter or Inferior Vena Cava Filter
In an inferior vena cava filter placement procedure, your interventional cardiologist uses image guidance to place a filter in the inferior vena cava (IVC), the large vein in the abdomen that returns blood from the lower body to the heart. Blood clots that develop in the veins of the leg or pelvis, a condition called deep vein thrombosis (DVT), occasionally break up and large pieces of the clot can travel to the lungs. An IVC filter traps large clot fragments and prevents them from traveling through the vena cava vein to the heart and lungs, where they could cause severe complications or even death. For More information, please refer to booklet IVC filter for DVT (Tab Patient Education/Link Booklets and Videos/Select Title).
TOP
Renal Angiography
Renal angiography (x-ray of the arteries supplying blood to the kidneys) is performed for patients with elevated blood pressure or impaired kidney function suspected of being due to blockage of the arteries supplying the kidneys. Patients with elevated blood pressure due to blockage of the arteries are candidates for angioplasty (repair of the artery using a balloon) if they are on 3 or more blood pressure medications or have intolerable side effects of fewer medications. In addition all patients with impaired renal function and blockage of both renal arteries are candidates for angioplasty.
Renal Angioplasty and Stenting
Narrowing or blockage of the renal artery (the main blood vessel that supplies the kidneys) can cause severely high blood pressure or problems with kidney function. Angioplasty is a procedure that uses a small balloon to widen the passage through a blood vessel. A stent is a small metal mesh tube put into a blood vessel to help hold it open. Renal angioplasty and stenting can help improve blood flow to the kidney and relieve problems. For more information, see a 6 minute video about Renal Artery Stenosis (Tab Patient Education/Link Booklets and Videos/Select Title).
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