By Our Staff Reporter
Dehradun, 2 Mar: In a first of its kind procedure in Uttarakhand, a team of doctors at Max Super Speciality Hospital, here, saved the life of a 67-year-old patient by performing a combination of rota ablation and coronary Shockwave Lithotripsy procedure.
The team of doctors led by Dr Preeti Sharma along with Dr Punish Sadana performed the procedure to open up a severely calcified and blocked artery of the patient who recently had a heart attack.
Explaining the need for the procedure, Dr Preeti Sharma, Associate Director, said, “This calcification happens in 20-25% of the patients undergoing angioplasty and stenting, especially those who are old, diabetic, have chronic kidney disease, or have long standing blockage. The other available options were to crack the calcium with angioplasty using a very high pressure balloon, but due to the amount of calcium, the concern was that this would either not work or lead to complications such as vessel rupture or perforation.
“At Max Hospital, we routinely perform angioplasties with rotablation for severely calcified arteries but, due to the amount of calcium and especially because the calcium was deep and not superficial in this case, rota ablation alone was not an ideal option. For this patient, we had to combine rota with Shockwave Intravascular Lithotripsy (IVL),” she added.
Rota ablation is used for removing the superficial calcification and IVL for deep calcification.
This patient was earlier suggested bypass surgery but due to his poor pulmonary function and severe respiratory problems (COPD) he was taken up for angioplasty.
Dr Punish Sadana added, “It is a major advancement over the previous techniques used for such hard blockages like ultra-high-pressure balloons or rotatory drills, which are difficult to use and carry risk of rupturing the artery. Because of severe calcification in all three arteries we used rota & IVL for lesion preparation in this case. The balloon was inserted inside the heart artery and sonic pulses were delivered to break the calcium in the blockage. The procedure weakened and cracked the calcium, allowing the balloon to expand, making placement of the stent easier and safer. After that the blockage opened easily at even low pressures with subsequent stent implantation making it an extremely successful procedure.”
