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Percutaneous techniques for the treatment of cerebrovascular disease and care of patients afterward are being studied at Washington Adventists Hospital (Takoma Park, MD). They are potentially safer and more cost-effective than the alternatives and can be used to treat lesions that are not accessible surgically. Percutaneous techniques, involving the technique of stent-supported carotid angioplasty (SSCA), may be an alternative method, especially for those most at risk, to carotid endartectomy. Though effective, the latter method has limitations.

Percutaneous cardiopulmonary support (PCPS) for high-risk angioplasty patients can be started in the catheterization laboratory before coronary revascularization. It can provide the hemodynamic support needed to make it possible for the patient to tolerate the high-risk procedure. At Washington Adventist Hospital (Takoma Park, MD), PCPS is being used, and the clinical applications, risks/benefits and implications for the critical care nurse are being studied. Some patients may not survive long enough to undergo emergency open-heart surgery; acute vessel closure may occur.