All over the world, the most common and problematic heart disease at present is coronary artery disease which means blockages developing in the blood vessels of the heart. We all have three blood vessels that supply blood and nutrients to the heart muscle continuously so that the heart can perform its function efficiently. If there is an issue, it is recommended to get the complex and advanced angioplasty in Chennai to lead a healthy lifestyle.
Coronary Artery Disease and Risk Factors
Atherosclerosis is the disease process that causes the accumulation of cholesterol and inflammatory cells in the inner layer of blood vessels of the heart and brain leading to heart attack and stroke leading to advanced angioplasty. This is due to either inadequate control of risk factors like hypertension, diabetes mellitus, dyslipidemia, and obesity, or improper lifestyle-related factors like smoking, stress, obstructive sleep apnoea, sleep disorders, and unhealthy dietary habits.
Disease Progression and Symptoms
Our heart has a high degree of compensatory process so that symptoms like chest pain, and breathlessness do not develop until the blockages in the blood vessels reach more than 70% severity. In diabetics and older age people because of neuropathy symptoms develop only after the blockages reach 90% severity. When the blockages suddenly rupture (plaque rupture) the blood clots over the preexisting blockage and leads to 100% occlusion which is the reason for heart attack and requires immediate attention from the angioplasty specialist in Chennai.
Importance of Early Diagnosis and Prevention
In order to diagnose the disease earlier we need to be proactive and undergo regular periodic health checkups including ECG, Echocardiogram, and Treadmill test (stress ECG). To prevent the disease from developing we need to lead a healthy lifestyle and if risk factors are present, we need to control them with medications appropriately or get the best complex and advanced angioplasty in Chennai.
A coronary angiogram is a test to identify the blockages in the blood vessels of the heart, it takes 15-20 minutes usually for the test procedure and the patient has to stay in the hospital for a further 4 hours for observation. If the blockage is more than 70% medications will not work and we need the treatment procedure called complex coronary angioplasty (stent treatment). Angioplasty can be categorized as a straightforward or advanced procedure.
Nearly 80% of the complex and advanced angioplasty in Chennai are straightforward, which normally takes 45 minutes to 1 hour for the procedure and a total of 2-3 days stay in the hospital. Whereas in tertian patients the blockages are complex lesions that will require advanced expertise from interventional cardiologists, cath lab team, additional hardware, and intra-coronary imaging for a safe and durable procedure.
This type of complex lesion is present in post-bypass surgery patients, calcified lesions in old age, chronic total occlusion, bifurcation lesions, left main lesions, chronic kidney disease patients, and severe LV dysfunction patients.
Types of Angioplasty Procedures
In certain patients apart from cholesterol, blockage calcium also starts depositing leading to very hard plaques and stents cannot be deployed or expanded. These patients in the past were sent for bypass surgery by the angioplasty specialist in Chennai. But now calcium can be modified using many additional interventional procedures like Rotablation, Intravascular shock wave lithotripsy balloons (IVL balloons), Cutting balloons, and Double layered NC balloons.
Rotablation is a technique used during the complex and advanced angioplasty in Chennai where a diamond-coated small conical-shaped burr rotates inside the blood vessels (1,60,000 to 2,00,000 RPM) and shaves the calcium into small pieces (< 7 microns) which are washed away into the microcirculation. IVL balloon is a new technology where the balloon emits shock waves that make cracks in the calcified lesion and allow the stent to expand.
In left main lesion and bifurcation lesions needing a double stent technique, intra-coronary imaging either Intravascular Ultrasound (IVUS) or Optical Coherence Tomography (OCT) will help in understanding the structure and distribution of blockages inside the blood vessels. These imaging catheters used during the complex coronary angioplasty help in visualizing the inside of the plaques as live images. This helps in optimizing the stenting procedure leading to good long-term outcomes.
Considerations for Chronic Kidney Disease Patients
In chronic kidney disease patients, it is better to avoid injection of iodine contrast to visualize the coronary arteries during the complex and advanced angioplasty in Chennai. In recent times we do ultra-low volume contrast angioplasty using IVUS techniques so that further kidney damage due to contrast is avoided.
In chronic total occlusion lesions, the blockage develops slowly and reaches 100% as a hard plaque. Since the lesion is total and hard, additional special CTO wires with hard tip load are needed to penetrate the lesion. Sometimes the wire is passed backward through small collateral vessels which is called retrograde technique to open the blood vessel blockages.
In certain CTO patients, laser energy is utilized to penetrate the uncrossable lesions. In patients with heart attack and cardiogenic shock where the blood pressure is very low, high-risk complex angioplasty is performed after initiating Mechanical Circulatory Support (MCS) devices in the form of VA ECMO or IMPELLA pump device. This is also utilized in chronic severe LV dysfunction patients who need angioplasty procedures.
Complex and Advanced Angioplasty in Chennai
When it comes to complex and advanced angioplasty procedures in Chennai, Dr. M. Kathiressan is a renowned expert. With a wealth of experience and cutting-edge technology at his disposal, he specializes in addressing intricate coronary artery conditions, including chronic total occlusions and complex blockages.
Dr. Kathiressan’s expertise ensures successful outcomes and improved quality of life for patients facing challenging cardiovascular issues. He is dedicated to providing personalized care and innovative solutions, making him a trusted choice for those seeking advanced angioplasty treatments in Chennai. When it comes to your heart health, trust in the skills and experience of Dr. M. Kathiressan.
Although all the procedures of complex and advanced angioplasty in Chennai lead to additional costs they help to avoid bypass surgery for patients who are at higher risk for surgery. It should be emphasized that many patients will still need bypass surgery because of other medical reasons.
Also, Read Rotational Atherectomy / Rotablation.