Complex Coronary Interventions
Some patients require more advanced angioplasty techniques, especially when dealing with challenging or heavily calcified blockages. These complex procedures, performed by experienced interventional cardiologists, involve additional technology and skill. Dr. Sai Satish, a pioneer in complex coronary procedures with over 10,000 interventions and a high volume of rotablations annually, is also an International Proctor for these techniques. Below are some types of complex coronary interventions:
- Multi-Vessel Stenting: In cases where multiple coronary arteries are blocked, stents are placed in each affected vessel to restore blood flow.
- Left Main Stenting: The left main coronary artery supplies most of the heart muscle. Stenting this critical artery is a highly complex and technically demanding procedure.
- Chronic Total Occlusions (CTO): When a coronary artery is completely blocked for an extended period, specialized tools and techniques are used to open it and restore blood flow.
- Calcified Lesions: Heavily calcified blockages require special approaches, like rotablation, to break up the hardened plaque.
- Graft Vessel Stenting: Patients who have undergone coronary artery bypass grafting (CABG) may develop blockages in graft vessels, both venous and LIMA (left internal mammary artery). Stenting these vessels can help restore blood flow post-surgery.
Advanced Tools for Complex Angioplasty
Several tools enhance the precision and effectiveness of complex coronary angioplasties. Dr. Sai Satish’s expertise in using these advanced tools ensures better outcomes for patients with complicated heart conditions.
- Rotablation: For calcified blockages, a small drill called a rotablator with a diamond-coated burr grinds away hardened plaque, allowing blood to flow more freely. Dr. Sai Satish is among the highest-volume rotablation practitioners in India, performing over 90 cases annually.
- Optical Coherence Tomography (OCT): This imaging technology uses light waves to provide high-resolution images of the artery, helping to assess the plaque and ensure precise stent placement.
- Intravascular Ultrasound (IVUS): IVUS provides detailed cross-sectional images of the coronary artery, enabling a more accurate assessment of vessel size and plaque burden, which is essential for complex stenting.
- Intravascular Lithotripsy (IVL): For severely calcified lesions, IVL delivers controlled sonic pressure waves to fracture calcified plaque, making it easier to expand the artery with a stent.
- Impella: For patients with severely diseased hearts, an Impella device acts as a temporary mechanical pump, supporting the heart during high-risk procedures, such as unprotected left main angioplasty. Dr. Sai Satish’s extensive experience with Impella provides an extra level of safety for critically ill patients undergoing complex interventions.
Coronary Angioplasty
Coronary angioplasty is a widely performed and minimally invasive procedure to treat blocked arteries, with around one million procedures done annually in the United States and approximately 450,000 in India. This technique restores blood flow in blocked or narrowed coronary arteries, often without the need for general anesthesia. Patients experiencing chest discomfort or at risk of a heart attack due to arterial blockages may benefit from angioplasty, which can be performed during the same visit as a diagnostic angiogram if blockages are identified.
In angioplasty, a balloon-tipped catheter is used to widen the narrowed artery. The balloon is inflated to push plaque against the artery wall, then removed, allowing improved blood flow. A small wire mesh tube, called a stent, is typically placed to keep the artery open after ballooning.
Dr. Sai Satish’s dedication to excellence and patient wellbeing drives his commitment to using these innovative techniques to help patients with advanced heart conditions achieve optimal outcomes, enabling them to lead healthier, more active lives.