Diagram of<unk>  placement. In A, the catheter is inserted across the lesion. In B, the balloon is inflated, expanding the<unk>  and compressing the plaque. In C, the catheter and deflated balloon have been removed. Before-and-after cross sections of the artery show the results of the<unk>  placement. Arterial<unk> ing 3D Medical Animation An artery with a<unk>  follows the same steps as other angioplasty procedures with a few important differences. The interventional cardiologist uses angiography to assess the location and estimate the size of the blockage ("lesion") by injecting a contrast medium through the guide catheter and viewing the flow of blood through the downstream coronary arteries. Intravascular ultrasound (IVUS) may be used to assess the lesion's thickness and hardness ("calcification"). The cardiologist uses this information to decide whether to treat the lesion with a<unk>  and if so, what kind and size. Drug-eluting<unk> s are most often sold as a unit, with the<unk>  in its collapsed form attached to the outside of a balloon catheter. Outside the US, physicians may perform "direct<unk> ing", where the<unk>  is threaded through the lesion and expanded. Common practice in the US is to predilate the blockage before delivering the<unk> . Predilation is accomplished by threading the lesion with an ordinary balloon catheter and expanding it to the vessel's original diameter. The physician withdraws this catheter and threads the<unk>  on its balloon catheter through the lesion. The physician expands the balloon, which deforms the metal<unk>  to its expanded size. The cardiologist may "customize" the fit of the<unk>  to match the blood vessel's shape, using IVUS to guide the work. It is critically important that the framework of the<unk>  be in direct contact with the walls of the vessel to minimize potential complications such as blood clot formation. Very long lesions may require more than one<unk> —the result of this treatment is sometimes referred to as a "full metal jacket". The procedure itself is performed in a catheterization clinic ("cath lab"). Barring complications, patients undergoing catheterizations are kept at least overnight for observation. Dealing with lesions near branches in the coronary arteries presents additional challenges and requires additional techniques.
Coronary stent
Transmyocardial revascularization
Percutaneous coronary intervention
Valvulotomy
Coronary artery bypass surgery
Cardiomyoplasty
Totally endoscopic coronary artery bypass surgery
Hybrid coronary revascularization