How is PCI different from bypass surgery?

Bypass surgery is open-heart surgery. PCI is a minimally invasive procedure that is done by an interventional cardiologist with the help of a catheter into your groin or arm

Why is my stent medicated?

In stents made up of only metal (Bare Metal stents), it was observed that the incidence of blood clot formation was higher. That is why a stent with a coating of the drug also called Drug-eluting stent or medicated stents are preferred. They release the drug at aslow rate to prevent blood clots from forming in a stent and thus prevent future blockage (restenosis) of the stent.

Understanding Calcium Build-up in the Heart: Symptoms and Treatment Options

The Calcium Conundrum: Disease and Treatment Options

29 December 2023

The heart is the most vital organ in the human body, pumping blood and ensuring the supply of oxygen & nutrients to various body parts. Calcium buildup in the coronary arteries can lead to blockages, which can cause heart attacks and other serious health complications. In this blog, we will discuss the symptoms of blocked coronary arteries and the treatment options available to treat calcium buildup in coronary arteries.

What is Calcium Buildup in Coronary Arteries?

If you find any symptoms of heart disease due to blocked coronary arteries, contact the nearest medical help for immediate treatment, as the delay can worsen the situation.

Calcium deposits in coronary arteries can develop over time, resulting from atherosclerosis, making vessel walls rigid and resistant to dilation. The presence of Calcium poses several challenges during PCI:

To address these challenges, interventional cardiologists have developed and refined several specialized techniques. Here, we delve into three techniques to treat Calcium Conundrum:

Procedure Steps:

1. Guidewire Placement:
A guidewire is inserted into the affected coronary artery to guide the procedure.

2. Microcatheter Insertion:
A specialized microcatheter is threaded over the guidewire to deliver the Rotablation device.

3. Rotational Atherectomy:
The Rotablation burr rotates at high speeds and is advanced to the calcified lesion. The burr grinds away the Calcium, creating a larger lumen.

4. Post-Ablation Assessment:
The physician assesses the vessel’s size and condition once the calcified plaque is removed.

5. Balloon Angioplasty and Stent Placement:
After successful plaque removal, balloon angioplasty and stent placement can be performed more effectively.

Rotational Atherectomy is highly effective in modifying heavily calcified lesions, allowing for better stent deployment and improved long-term outcomes.

Procedure Steps:

1. Guidewire Placement:
Similar to other PCI procedures, a guidewire is advanced to the target lesion.

2. Cutting Balloon Inflation:
The cutting balloon is positioned at the site of the calcified lesion and inflated to a low pressure.

3. Blade Expansion:
As the balloon inflates, the tiny blades or scissors on its surface make controlled incisions into the calcified plaque.

4. Post-Procedure Assessment:
After plaque modification, the vessel’s condition is assessed, and further interventions, such as stent placement, may be performed.

Cutting Balloon Therapy treats calcified lesions by creating micro-incisions, allowing controlled and less traumatic plaque modification.

Procedure Steps:

1. Guidewire Placement:
As with other PCI procedures, a guidewire is positioned in the affected artery.

2. Laser Catheter Insertion:
A specialized laser catheter is advanced to the site of the calcified lesion.

3. Laser Ablation:
Laser energy is emitted from the catheter tip, vaporizing or ablating the calcified plaque. Different types of lasers are used, including excimer lasers and thulium lasers.

4. Debris Removal:
A vacuum catheter or aspiration device is often used simultaneously to remove the debris created during laser ablation.

5. Post-Laser Assessment:
The vessel’s condition is assessed post-laser ablation, and additional interventions, such as stent placement, may be performed as needed.

Laser Therapy offers precise and controlled removal of calcified plaques, making it a valuable option in challenging cases.

Conclusion

The Calcium Conundrum remains a significant challenge in interventional cardiology. Still, advancements in techniques like Rotational Atherectomy, Cutting Balloon Therapy, and Laser Therapy have transformed the management of heavily calcified lesions. These specialized procedures enable more effective plaque modification, facilitating better outcomes in patients with coronary artery disease. As technology continues to evolve, the future of cardiac care holds promise for even more innovative approaches to tackle the Calcium Conundrum and improve the lives of patients affected due to cardiovascular diseases.

References:

1. https://india.apollohospitals.com/heart-disease/coronary-artery-disease-calcium-buildup/
2. https://www.medanta.org/patient-education-blog/understanding-coronary-artery-calcification-cac/
3. https://www.maxhealthcare.in/blogs/heart-vascular-diseases/what-is-coronary-artery-calcification-and-why-it-is-a-concern/
4. https://www.fortishealthcare.com/india/diseases/coronary-artery-disease-236
5. https://www.manipalhospitals.com/blog/coronary-artery-calcification-causes-symptoms-treatment

Disclaimer: The information presented by Boston Scientific India is for educational purposes only and does not recommend self-management of health issues. The information should not be treated as comprehensive and does not intend to provide diagnosis, treatment or any medical advice. Individual results may vary and hence, it is advisable to consult your doctor regarding any medical or health related diagnosis or treatment options.

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