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:
- 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) Emergenc Patients
with heart attacks or with reduced pumping of heart/heart failure (E) Sick patients with low blood
pressure and/or abnormal cardiac rhythms.
- 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.