Editing Cardiac catheterization (section)

==Procedure==
"Cardiac catheterization" is a general term for a group of procedures. Access to the heart is obtained through a peripheral artery or vein. Commonly, this includes the [[radial artery]], [[internal jugular vein]], and [[femoral artery]]/[[femoral vein|vein]]. Each blood vessel has its advantages and disadvantages. Once access is obtained, plastic catheters (tiny hollow tubes) and flexible wires are used to navigate to and around the heart. Catheters come in numerous shapes, lengths, diameters, number of lumens, and other special features such as electrodes and balloons. Once in place, they are used to measure or intervene. Imaging is an important aspect to catheterization and commonly includes fluoroscopy but can also include forms of [[echocardiography]] ([[transthoracic echocardiogram|TTE]], [[transesophageal echocardiography|TEE]], [[intracardiac echocardiography|ICE]]) and ultrasound ([[intravascular ultrasound|IVUS]]).{{citation needed|date=March 2021}}

Obtaining access uses the [[Seldinger technique]] by puncturing the vessel with a needle, placing a wire through the needle into the lumen of the vessel, and then exchanging the needle for a larger plastic sheath. Finding the vessel with a needle can be challenging and both ultrasound and fluoroscopy can be used to aid in finding and confirming access. Sheaths typically have a side port that can be used to withdraw blood or inject fluids/medications, and they also have an end hole that permits introducing the catheters, wires, etc. coaxially into the blood vessel.{{citation needed|date=March 2021}}

Once access is obtained, what is introduced into the vessel depends on the procedure being performed. Some catheters are formed to a particular shape and can really only be manipulated by inserting/withdrawing the catheter in the sheath and rotating the catheter. Others may include internal structures that permit internal manipulation (e.g., [[intracardiac echocardiography]]).{{citation needed|date=March 2021}}

Finally, when the procedure is completed, the catheters are removed and the sheath is removed. With time, the hole made in the blood vessel will heal. [[Vascular closure device]]s can be used to speed along hemostasis.

===Equipment===
Much equipment is required for a facility to perform the numerous possible procedures for cardiac catheterization.

General:{{citation needed|date=March 2021}}
* Catheters
* Film or Digital Camera
* Electrocardiography monitors
* External defibrillator
* Fluoroscopy
* Pressure transducers
* Sheaths

Percutaneous coronary intervention:{{citation needed|date=March 2021}}
* [[Coronary stent]]s: [[bare-metal stent]] (BMS) and [[drug-eluting stent]] (DES)
* [[Angioplasty]] balloons
* [[Atherectomy]] lasers and rotational devices
* [[Left atrial appendage occlusion]] devices

Electrophysiology:{{citation needed|date=March 2021}}
* [[Catheter ablation|Ablation]] catheters: radiofrequency (RF) and cryo
* [[Artificial cardiac pacemaker|Pacemaker]]s
* [[Implantable cardioverter-defibrillator|Defibrillator]]s