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The Future of Angioplasty is Right Here!

Jul 31, 2024

Laser Angioplasty: A Revolutionary Approach in the Treatment of Complex Cardiovascular Disease

Laser angioplasty is a minimally invasive procedure used to treat blockages or narrowings within arteries. Unlike traditional angioplasty, which involves the inflation of a balloon to compress plaque against the arterial walls, laser angioplasty uses laser energy to vaporize or remove plaque buildup. This approach is particularly useful in cases where balloon angioplasty alone may be insufficient due to calcified or otherwise stubborn plaque.

Description

A specialized laser catheter, equipped with a fiber optic tip, is inserted over the guidewire and positioned at the site of the blockage. Once the laser catheter is in place, the surgeon activates the laser, delivering high-energy pulses of light to the plaque. The laser energy vaporizes or ablates the plaque, creating a channel within the artery. In some cases, balloon angioplasty is performed after laser ablation to further widen the artery and ensure that it remains open. A stent may also be inserted to provide long-term support to the artery.

After the procedure is completed, the catheter is removed, and the incision site is closed. Patients are typically monitored for a brief period before being discharged. Laser angioplasty allows for precise removal of plaque, even in calcified or complex lesions, reducing the risk of complications and restenosis. The procedure is minimally invasive, requiring only a small incision, and is often performed on an outpatient basis, reducing hospitalization time and recovery. Patients usually experience a faster recovery time compared to traditional open surgical procedures. Laser angioplasty minimizes the risk of damage to the arterial walls, reducing the likelihood of complications such as dissections or perforations. By effectively removing plaque, laser angioplasty can lead to improved long-term outcomes and reduce the need for repeat interventions.

As we all know, coronary artery disease is increasing like a pandemic across the globe. The incidence and prevalence are rapidly rising in India, particularly in our state, Kerala. We live in an era of lifestyle diseases, which are major risk factors contributing to the high incidence of coronary artery disease in our country. The best approach to this is prevention, mainly through lifestyle modification. However, once coronary artery disease is established, we have only three treatment options: medical management, coronary angioplasty, and coronary artery bypass surgery. In cases of acute coronary syndrome, emergency angioplasty is the best treatment option to reduce mortality and save the patient.

Image guidance technologies like IVUS (Intravascular Ultrasound) and OCT (Optical Coherence Tomography) provide greater precision and long-term results in angioplasty. Traditionally, very complex blockages were treated with bypass surgeries, while simpler blockages were treated with angioplasty, and non-flow limiting CADs were managed with strict medical management.

Thanks to continuous technological advancements in the field of cardiology, we can now handle more complex blockages with angioplasty. Previously, complex blockages in the heart vessels, such as triple vessel disease, significant left main disease, calcified blocks, bifurcation lesions, and chronic total occlusions, required bypass surgery. But recent technological advancements are assisting cardiologists in tackling more challenging blockages with angioplasty.

Conclusion

Laser angioplasty is particularly effective in breaking down and removing heavily calcified plaques that may be resistant to balloon angioplasty. When stent re-narrowing (restenosis) occurs, laser angioplasty can help to reopen the stent and restore blood flow. Laser angioplasty is also used to treat chronic total occlusions (CTOs), which are long-standing blockages that are difficult to pass with traditional angioplasty.

Laser angioplasty is a revolutionary advancement in the treatment of cardiovascular disease, offering a highly effective and minimally invasive option for patients facing arterial blockages and plaque buildup. With its precision, reduced complication rate, and faster recovery times, laser angioplasty has the potential to significantly improve the quality of life for individuals suffering from coronary artery disease and peripheral artery disease.

Since its inception in 2012, MICC has been at the forefront of fighting heart disease. With a team of passionate doctors and paramedical staff in the field of cardiology, we have been able to provide better outcomes in complex cardiovascular diseases. We believe that the introduction of laser in interventional cardiology for the first time in North Kerala will be beneficial for many patients in this part of the state with tough coronary artery disease.