ROTABLATION ANGIOPLASTY AND STENTING! (DR BINOY JOHN)
WHAT IS ROTABLATION ANGIOPLASTY?
ROTABLATION ANGIOPLASTY is a complex angioplasty done in the coronary arteries or blood vessels of the heart, much different from the conventional balloon angioplasty, in that, this angioplasty is performed in heavily calcified blocks which do not open with balloons. The blocks do not yield to balloon pressure as the blocks are full of calcium which makes it as hard as rock. The balloons may also at times burst in such blocks.
Thus calcified blocks, mostly seen in elderly people can be opened only with a tool called rota-burr and rotablation. Rotablation involves passing drills into these blocks and abrading away the calcium. These burrs rotate at speeds of 200,000 rotations per minute inside these 2.0 to 3.0 mm arteries, making it a procedure needing high skill, precision and experience to avoid life threatening complications.
This video shows a 2 burr rotablation angioplasty followed by placement of 2 stents in a 71 year old man who had highly calcified blocks. The procedure was over in less than 2 hours and the patient walked out of the hospital in just less than 48 hours.
In the skilled hands, angioplasty can be used to treat almost 99% of coronary artery disease and thus avoiding a morbid procedure as Coronary artery by-pass graft (CABG) surgery which has numerous complications like long stay in the hospital, general anesthesia risk, bleeding, infection, non-healing of wounds and getting back to a normal life style taking as long as 3 months. CABG surgery has its value though, in very select cases.
DR BINOY JOHN
MD; DM (CARDIOLOGY) FCSI; FACC; FESC; FSCAI; FAPSIC
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