Coronary

Over the last two decades, coronary angioplasty, stenting and other percutaneous procedures have revolutionized the treatment on coronary artery disease.

The anatomy of the coronary arteries is defined by Coronary Angiography.

Whilst the standard method of coronary angiography is via puncture of the femoral artery in the groin, it is now possible to perform coronary angiography and angioplasty via the radial artery in the hand. This makes it very convenient for the patient, as it does not require complete bed rest, and the patient can be discharged within a few hours ( Figure 3 ).

A coronary balloon is initially used to dilate the Stenosis in the coronary artery, and make the way for implantation of a stent ( Figure 4 ).

Stents are metallic springs, usually made of stainless steel, which are positioned inside the coronary arteries, so as to prevent the artery from closing down after balloon angioplasty. Stents are also known to prevent the recurrence of restenosis and reblockage of the coronary arteries. Newer stents are coated with special drugs such as Rapanycin or Paclitaxel, which have markedly decreased the incidence of restenosis and made coronary angioplasty a preferred mode of treatment for coronary artery disease. It is safe to say, that nowadays, with the availability of medicated stents, patients of coronary artery disease will be sent to surgery only if angioplasty is technically not possible.

Current Indications for Coronary Angioplasty:
1. Unstable angina
2. Unstable angina / Acute Coronary Syndrome
3. In presence of Acute Myocardial Infarction
4. Angina after Myocardial Infarction
5. After bypass surgery, when surgical grafts get narrowed or new lesions form in native coronary arteries
6. In patients who are at high risk for coronary bypass surgery e.g.Elderly, renal failure, emphysema, etc.
7. Angioplasty in multivessel disease, in patients who do not wish for a surgical procedure.
 
View the Case Studies for Coronary Angioplasty....