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Bifurcation Angioplasty Safe Option for Lesions

Published: 12th July 2015 03:23 AM  |   Last Updated: 12th July 2015 03:23 AM   |  A+A-

HYDERABAD: Heart patients suffering from  bifurcation lesions can heave a sigh of relief as Bifurcation Angioplasty (BA), the latest development in the field of coronary angioplasty can provide successful treatment options.

Bifurcation lesions means narrowing and blockage of arteries at the bifurcation of blood vessels. The point where bifurcation of vessels occurs is also referred as Y junction by cardiologists.

The coronary artery tree of blood vessels has a main coronary artery which branches into several side branch vessels to distribute blood throughout the body. The area where artery branches into a vessel is called bifurcation and the occlusion formed on both sides of the junction is called bifurcation lesion and the angioplasty performed to clear the blockage of Y junction is bifurcation angioplasty, said Dr K Sarat Chandra, cardiologist at the Indo-US Super Specialty Hospital.

Though interventional cardiologists have mastered treating blockages in arteries quite successfully, treating blockages formed at the bifurcation of blood vessels is said to be complex.

If we treat the blockages at bifurcation by placing a stent in the artery, there is a danger that the other artery gets closed thus putting the life of patient in danger.  To ensure that the other artery does not gets closed cardiologists place a wire in the other artery and put a stent in the artery where lesion occurs, explained Dr Sridhar Kasturi, interventional cardiologist at Sunshine Hospitals.

Cardiologists earlier used to perform bypass surgery for patients, but patients were unable to recover completely. Bifurcation angioplasty is seen as a boon for patients suffering from bifurcation lesions.

But this coronary intervention is not simple and requires lot of dexterity and appropriate selection of stents to make it safe and successful. Also each patient has to be diagnosed and evaluated individually.

With 30 to 40 percent of patients going for angioplasties are due to blockages at Y junction of arteries, bifurcation angioplasty will greatly help them. Bifurcation angioplasty can improve the quality of treatment to a great extent. Though we are looking for even newer inventions for treating bifurcation lesions safely, for now BA is the best possible available treatment, Sridhar said.

Besides providing safer treatment option bifurcation angioplasty is not expensive and costs almost the same as normal angioplasty. Also with introduction of various newer versions of stents and advances in imaging techniques like Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT) lesions can be precisely located and angioplasty can be performed meticulously.

Inflammatory Bowel Disease on the Rise

As Inflammatory Bowel Disease (IBD), which do not have complete curative treatment is rising in India, Dr Uma Maheshwar Rao, gastroenterologist at Global Hospital, said. He speaks about the care to be taken to stop IBD from developing into advanced stages in an interview.

Dr Uma Maheshwar Rao.jpgExcerpts

What is Inflammatory Bowel Disease?

Many confuse Inflammatory Bowel Disease (IBD) with irritable bowel syndrome (IBS). IBD is completely different from IBS. It is of two types: Ulcerative colitis (UC) and Crohns disease. Ulcerative Colitis is a disease in which the lining of colon (the large intestine) becomes inflamed and develops sores (ulcers), leading to bleeding and diarrhoea. It affects the rectum and lower part of the colon. Crohns disease can affect any part of the digestive tract from oral cavity to anal canal in the form of inflammation, strictures or ulcers. The problem is both forms of IBD are are not completely curable.

What are the causes of IBD?

The causes of IBD are not clearly known. . When a person with the inherited risk is exposed to a trigger (an illness or something in the environment), the immune system is activated. The immune system recognizes the lining of the colon as foreign and attacks it, leading to inflammation.

What are the symptoms?

In case of ulcerative colitis symptoms are intermittent rectal bleeding, mucus discharge from the rectum, mild diarrhoea, abdominal pain, constipation, frequent and lossy body stools, low blood count (anemia), fever, weight loss, among others. People also develop inflammation outside the colon sometimes. Besides the above said symptoms, Crohns symptoms include fatigue, mouth sores, skin problems, eye inflammation and anal problems.

 

What are the treatment options available for IBD?

Although ulcerative colitis cannot be cured, it can be controlled with medication. Surgery for removing the entire colon can be a curative option, but it cannot be offered to everyone with the disease. Similarly treating Crohns disease also involves both medication and surgery.  About 80 percent of people with Crohn disease will need surgery at some point in their life.

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