Indiana Hospital first to perform OCT-guided IVL angioplasty in Mangaluru

MANGALURU — Indiana Hospital and Heart Institute, Mangalore has been at the forefront of adopting newer technology for treatments. It has to its credit many milestones. Yet another feather was added to its cap when a team of doctors led by Dr. Yusuf Kumble, chief interventional cardiologist and managing director, has performed for the first time in Mangalore an OCT-guided Intravascular Lithotripsy (IVL) to get the blocks in the coronary blood vessels cleared on a 70-year-old lady patient from Kerala. She is now discharged and recovering well.

We are all aware that Kidney and gall bladder stones, one of the most common and most painful disorders of the urinary tract, are removed by lithotripsy, which breaks apart kidney stones that are too large to pass and thus ensures its removal. But, none might have heard about stone-like fragments in a heart in the form of calcium deposits.

Historically, lithotripsy is used to treat kidney ailments but this method is now used for heart procedures as well. In the new procedure Intravascular lithotripsy IVL – there is a device which is put across the blood vessels of the heart with the laser rays breaking down the calcium. The procedure is done every ten to twenty second. OCT helps to locate where exactly the calcium build-up was and after the procedure it will be known whether it is successfully crushed or not. After this, it will be easy to perform angioplasty.”

According to Dr. Yusuf Kumble, “Angioplasty is a big challenge when the walls of the arteries are accumulated with calcium build-up and becomes a nightmare for cardiologists. The innovative method enables removal of calcified deposits clogging the arteries making stent insertion smooth.”

He explained, “In order to check severely calcified vessels various methods, like CT scan, angiogram, etc are adopted. By this procedure we may not able to find out where exactly the calcium deposits are present in the wall, whether it is outside or inside of it. In order to crush them we need to understand where the calcium is accumulated. So, traditionally cardiologists make use of high pressure balloon to remove the calcium fragments or through a new technology now in vogue called rotational atherectomy.

It means there is a small revolving instrument used at very high speed, at 2 lakh per minute, that can pulverize the calcium deposit which is inside the wall of arteries but cannot crush which are in the middle or outside of it. After this procedure we try to implant the stent. In senior citizens due to calcium deposits in blood vessels, negotiating blocks and placing stents is not an easy task. The new-age treatment called IVL ensures a minimally invasive procedure that gives high success and minimal complications.”

Dr Yusuf Kumble prescribes, “The OCT-guided coronary Intravascular Lithotripsy (IVL) system is a promising method to tackle moderate to severe calcified coronary lesions, with a high rate of success and a low risk of complications.”

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