Vinayak Sen, a businessman from Pune, was in Chennai for work. He had a heart attack and was rushed to the hospital. However, due to delayed presentation to the hospital (more than 5 to 6 hours after the onset of symptoms), the cardiologist diagnosed a large quantity of clots in the blood vessel. The standard process of sucking the clot out or delivering medications was ineffective. Vinayak’s life was saved after doctors performed an emergency laser angioplasty.
“After a heart attack, the golden hour for opening blood vessels is within 60 minutes. In Vinayak’s case, he presented late and so there were large quantities of clots in the blood vessels. After normal techniques failed, he went into cardiogenic shock. As a result, we employed an intra-aortic balloon pump to assist circulation and a laser to ablate the blood clot. Blood flow was restored after 10 minutes of laser angioplasty,” says Dr R Anantharaman, Senior Consultant, Interventional Cardiologist, Kauvery Hospitals.
Vinayak recovered within a week’s stay in the Intensive Care Unit and flew home to be with his family in Pune. Experts opine that laser angioplasty is a game changer for high-risk patients.
ADVANCED TREATMENT
Coronary laser angioplasty is a cutting-edge treatment used to repair arterial blockages with calcium. In some cases, laser angioplasty aims to lessen the likelihood of open-heart surgery and improve the patient’s quality of life.
As in the case of an angioplasty, a laser is attached to a tiny balloon catheter and inserted into the blocked blood vessel. Unlike in an industrial context where infrared laser is employed, an ultra violet laser is used to vaporise calcium and blood clot deposits in a coronary situation.
“Laser angioplasty works through three mechanisms: photochemical, photomechanical, and photothermal, which aid in dissolving calcium deposits in the blood vessel and clearing the blood clot, making angioplasty more successful,” explains Dr Anantharaman.
According to experts, one of the challenges of angioplasty is the tenacious calcium deposits, necessitating surgery in patients. However, laser angioplasty can help in this situation. It dissolves the calcium deposits, allowing more patients to be healed without the need for open-heart surgery.
Dr Anantharaman adds that the major advantage of laser angioplasty is its ability to manoeuvre difficult and narrow parts in the heart blood vessels to eliminate blood clots.
PROCEDURE
A small incision near the patient’s groin or hand is made by the surgeon during a laser angioplasty, and a wire is inserted into the femoral artery and moved to the area where the fatty deposits are impeding blood flow.
With the help of the wire, a laser is inserted into the tube, and the laser burns the deposits on the artery walls. The doctors monitor the procedure using real-time X-ray pictures and contrast dyes. The wire is removed after the procedure and the incision is closed.
A laser angioplasty could take one to three hours, depending on the quantity of blood clots and the severity of the case. Most patients can be discharged in 24 hours. A laser angioplasty will cost an additional Rs 2 to 3 lakh on top of the angioplasty expense.
Talking about patients who will be ideal for laser angioplasty, Dr Anantharaman says that the first group of patients are those who already have a stent and when there is new tissue growth in the stent. In this scenario, a laser angioplasty would prove effective. Second group of patients are those who present with heart attack where laser angioplasty is used to quickly open a blocked artery and reduce the amount of damage to the heart. The third group of people are those who have high calcium deposit and normal angioplasty cannot be done since the blood vessel is not elastic. In this case, laser angioplasty will reduce the calcium deposits.
TRENDS IN LASER ANGIOPLASTY
Outlining recent trends, Dr Anantharaman says that the bulk of transplant patients are the clientele for laser angioplasty. “Cardiac surgery is often a risky procedure for transplant patients who have heavy calcium deposits. In these situations, laser angioplasty is a lifesaver. We have done these for lung transplant, renal transplant, and liver transplant patients,” he adds.
However, doctors also exercise caution. Laser angioplasty is not the only solution for clearing blockages. It is an additional adjunctive treatment for high-risk patients. While it may not be appropriate in all circumstances, it has made traditional angioplasty more successful and safer for patients.
Dr Anantharaman emphasises the need for a multidisciplinary team in treating coronary artery disease, adding that it takes a lot of personnel as well as sophisticated technology to achieve the greatest outcomes in surgery and patient care.
“With the addition of laser angioplasty, a hybrid cath lab operating room, and an internationally trained team of interventional cardiologists, the Cardiac Sciences Centre of Excellence in Kauvery Hospitals has become the first choice for cutting-edge treatment for those suffering from cardiac artery blockages,” he says.
TIPS FOR A HEALTHY HEART
According to a study conducted by the Indian Council of Medical Research and the Registrar General of India, India accounts for almost 60% of the global heart disease burden. Heart problems among young Indians have recently become a source of concern for health experts.
Dr Anantharaman shares the following tips to keep your heart healthy:
Regular physical activity keeps the mind and body fit and agile. Participate in physical activity for at least 30 minutes five times per week.
Make nutritional adjustments. Avoid greasy and processed foods heavy in sodium, trans fats, and preservatives. Consume a well-balanced diet.
Regular blood pressure, blood sugar, diabetes, and cholesterol screenings are essential for heart health. Get frequent heart checks, especially after the age of 35.
Try to live a stress-free life. Learn stress management techniques to reduce anxiety and palpitations.
Quit smoking and drinking.
Get a good night’s sleep of 7-8 hours.