Description

Complex Coronary Angioplasty is a treatment being given to the patients by using an Advanced Imaging Technologies like (IVUS & OCT). Complex angioplasties are technically more challenging as it requires expert Cardiologist hands to perform as it may take more time to perform, having lesser success rates, consume more dye/contrast, utilize more hardware and are more expensive. The factors that affect the success rate in Complex Angioplasties could be: (1) Clinical : Clinical features resulting in complex angioplasties include (A) Elderly Patients (B) Patients with other severe diseases of the lungs, kidneys, liver (C) Obese Patients (D) Emergency Patients with heart attacks or with reduced pumping of heart/heart failure (E) Sick patients with low blood pressure and/or abnormal cardiac rhythms. (2) Anatomical : Anatomical features resulting in complex angioplasty include (A) Multiple blockages (B) Long lesions (C) Severe Calcifications (D) Blockages of the Left Main Coronary Artery (E) Blockages involving bifurcations/trifurcations (branch points) (F) Chronic Total Occlusions (G) Lesions with a lot of blood clots, etc. To achieve consistent success rates in complex angioplasties a Cardiac center must be having a good Cathlab Infra-structure with the availability of all interventional tools including different types of guiding catheters, guide wires, balloons, rotablation, Intravascular Ultrasound, Intra-aortic Balloon Pump, etc. along with technically skilled Cathlab technicians and Nurses with hands on experience in dealing with such complex procedures is a must. Experienced operators and support from anesthetists hold the key to success in this challenging subset of cardiac patients. Meticulous techniques must be followed to ensure successful angioplasty. Since these procedures are done with significant risk, surgical back-up is essential in case of emergencies.

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