PUNE: A 70-year-old diabetic patient who had suffered a heart attack underwent Pune’s first laser-assisted, stent-less angioplasty at Sahyadri Super Speciality Hospital, Deccan Gymkhana. The revolutionary procedure, performed under the expertise of Dr. Abhijeet Palshikar, Director – Cardiology Sahyadri Super Speciality Hospital, Deccan Gymkhana marks a significant milestone in interventional cardiology.

The patient, who had a history of diabetes, experienced a mild heart attack three days before the procedure and was initially treated medically. However, doctors identified two key challenges, a heavy calcium buildup in his artery, which made traditional stenting difficult, and his reluctance to have a stent placed. To address these concerns, the medical team chose a laser-assisted angioplasty combined with a drug-coated balloon, which successfully opened the artery without needing a permanent metal stent.

The angioplasty procedure utilized an Excimer laser, a state-of-the-art technology that effectively clears calcium and cholesterol deposits within arteries. This was followed by the use of a drug-coated balloon, an innovative alternative to traditional stents. Instead of placing a permanent implant, the drug-coated balloon delivers medication to the artery and is then removed, leaving no metal behind.

Dr. Abhijeet Palshikar, Director – Cardiology at Sahyadri Super Speciality Hospital, Deccan Gymkhana explained the details and benefits of the procedure “The key benefits of the procedure include the absence of a permanent metal implant. Stents remain in the body permanently and may have risks of restenosis (artery re-narrowing). The laser-assisted approach eliminates this concern. Additionally, the patient experienced a faster recovery, being discharged within a day, walking independently, and resuming daily activities quickly. By the next day, he was mobile, walking independently to the restroom, and was discharged in the afternoon.”

“The success of this first-of-its-kind procedure in Pune paves the way for a new era in interventional cardiology, offering a safer and more effective alternative to traditional stenting methods which are minimally invasive alternatives.” Dr Sunil Rao, Chief Operating Officer and Medical Director at Sahyadri Group of Hospitals said.

The Excimer laser employed in the procedure is known for its precision in ablating calcified plaques, reducing risks while ensuring effective plaque removal. Additionally, drug-coated balloons provide targeted therapy, preventing restenosis without the need for permanent implants. With its many benefits, laser-assisted, stent-less angioplasty is expected to become a common procedure in the future, possibly replacing traditional angioplasty in many cases. It is not only useful for coronary artery disease but also for treating blockages in smaller blood vessels, where stents are less effective. The procedure is highly safe, with strict laser controls to reduce risks. It is also an excellent option for patients who have a blocked stent, as laser therapy can clear the obstruction without placing another stent.

“This breakthrough procedure offers a paradigm shift in angioplasty treatments. Patients who are hesitant about permanent stents or have complex calcified blockages now have an alternative that ensures better outcomes with reduced risks. The success of Pune’s first laser-assisted, stent-less angioplasty marks the beginning of a new chapter in cardiac care, and we anticipate its widespread adoption in the future.” Dr. Palshikar added.       

Sahyadri Hospital is renowned for its exceptional cardiac care and commitment to integrating the latest medical advancements to deliver superior patient outcomes.

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Vascular health plays a crucial role in maintaining overall well-being, yet the intricacies of endovascular procedures often remain shrouded in medical jargon. In this primer, we’ll break down various vascular procedures into digestible nuggets of information, ensuring that even the non-expert reader gains a comprehensive understanding of these vital interventions.

What is Endovascular Surgery?

Endovascular surgery is a minimally invasive approach to treating vascular conditions. Unlike traditional open surgeries, endovascular procedures involve entering the blood vessels through small needle holes, typically using catheters and wires.

Angiography

Angiography is like creating a road map of your blood vessels. Through this procedure, a catheter is threaded through blood vessels to inject contrast dye, enabling doctors to visualize blockages, aneurysms, or other abnormalities. It’s like taking a snapshot of the vascular system, providing crucial information for further treatment decisions.

Angioplasty

Imagine a traffic jam in your arteries caused by plaque buildup. Angioplasty is like sending a skilled road crew to clear the way. During this procedure, a balloon-tipped catheter is inflated at the site of the blockage, widening the narrowed vessel and restoring blood flow. Often, a stent (a small mesh tube) is placed to keep the vessel open.

Atherectomy

Think of atherectomy as the specialized clean-up crew. This procedure involves using a device to remove or cut away plaque from blood vessels. It’s like scraping off the gunk that’s clogging up the arteries, promoting smoother blood flow and reducing the risk of future complications.

Embolization

Sometimes, abnormal blood vessels or aneurysms need to be blocked to prevent complications. Embolization involves injecting substances or devices (emboli) to obstruct blood flow in specific vessels, effectively addressing the issue without invasive surgery.

Thrombolysis

When a blood clot threatens to block essential blood vessels, thrombolysis comes to the rescue. This procedure involves administering medications that break down clots, allowing blood to flow freely and preventing damage to vital organs.

Venous Access Procedures

For certain medical treatments, efficient access to veins is crucial. Procedures like central venous catheterization or perm cath placement involve creating entry points for medication administration, blood sampling, or dialysis, ensuring optimal vascular access for ongoing care.

Peripheral Arterial Disease (PAD) Treatments

PAD can restrict blood flow to the legs and arms, causing pain and limiting mobility. Treatments like atherectomy, angioplasty, and stenting can effectively manage PAD, improving circulation and relieving symptoms.

Endovascular Aneurysm Repair (EVAR)

An aneurysm is a bulge or ballooning of a blood vessel wall. EVAR involves placing a stent graft in the weakened area to reinforce it and prevent rupture. Think of it as patching up a tire with a puncture.

Understanding endovascular procedures is like deciphering the language of vascular health. By breaking down these interventions into relatable analogies, we hope to empower every reader with the knowledge to engage in informed discussions about their health. Remember, a clear understanding of these procedures fosters collaboration between patients and healthcare providers, leading to better outcomes and improved vascular well-being.

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