Minimally invasive procedures are making giant strides in areas where such interventions were unimaginable a few years ago. The success ratio, low risk and minimal scarring with this technology have made it the preferred choice for the surgeons as well as the patients. The latest surgical turf technology is gaining accreditation among cardiologists.
Cardiac surgeons see the laser tech as a game changer with the potential of serving as a promising alternative to bypass surgeries as well as a great aid in performing complex angioplasty procedures. Besides, the recovery period after the procedure is comparatively much shorter than the traditional procedures.
According to Dr Udgeath Dhir, director and Head of Cardiothoracic and Vascular Surgery (CTVS), Fortis Memorial Research Institute, Gurugram, Transmyocardial revascularization was the key for the usage of lasers in cardiac surgical procedures, where special CO2 lasers are used to treat patients with end-stage coronary disease who don’t respond to medications or other interventions.
“However, the technology is now used in angioplasty, in cases which are not amenable to bypass surgery. It’s especially a great choice in acute procedures where surgical wires are unable to pass through the occlusion (blockage in the artery),” he said.
High-energy laser catheters are engineered to emit focused beams with pinpoint accuracy on the calcified blockages in the arteries. This innovative approach allows surgeons to precisely target and vaporise plaque buildup and restore the blood flow in the vessels. The laser energy also seals the treated area, reducing the risk of restenosis or re-narrowing.
“Laser therapy has revolutionised our ability to treat patients, especially in complex cases with multiple blockages or total blockages. Previously, we often considered these cases untreatable, however with laser therapy, we can perform effective angioplasties, and patients can be discharged within just one day,” said Dr Praveen Chandra, chairman - Interventional & Structural Heart Cardiology, Heart Institute, Medanta, Gurugram. Given the momentum laser is gaining in cardiac care, many have argued that it may replace traditional stents. In many recorded cases, the laser has cleared the blood passage so effectively that patients did not require a stent afterwards.
However, experts are not buying this theory. “It is not going to replace the stent but will aid the surgeons in placing a stent in the area which could not have been possible earlier due to the risk involved in creating the channels. The main purpose for them (laser technology) is to create a path for the angioplasty However, they will be adding to the robotic technology and will ultimately help in making those procedures safer for complex cases which seem undoable with the previous technology,” Dhir said.
“No, laser therapy doesn’t replace traditional stents. In fact, in about 30-40% of cases, we can perform procedures without the need for stents, using laser and balloon angioplasty instead. Laser therapy’s primary application is in cardiac care at the moment,” Chandra added.
However, the experts also gave hope for the expansion of laser technology in other areas. “The scope of laser in cardiovascular surgeries is expanding. Soon, they will be used in arrhythmia surgeries as well,” Dhir said.
But how safe is the technology? Experts say that the medical fraternity has approved the clinical significance of using lasers in coronary treatment. “There have been phases of clinical trials followed by regulatory approval. Besides, there are guidelines of case selections where this modality could be used,” Dr Dhir said.
Chandra also corroborated and said that laser therapy for cardiac care has received approval both worldwide and in India. “It has proven to be quite effective, particularly in challenging situations where angioplasty was previously not possible. While laser therapy is not exclusive to India, in this part of Asia and among Asian countries, India is indeed one of the pioneers in utilising this technology,” he added.
The treatment is available between Rs 1.5 lakh and Rs 3 lakh in the hospitals. The experts said that the cost is not exorbitantly high but more expensive than the traditional procedures.
“The cost of laser therapy is not exorbitantly high. While it is somewhat more expensive than traditional methods, it is within reach for many patients and not prohibitively expensive,” Chandra said.
“Every new technology is a little costly. It’s not too cheap but not costlier than a human life. A successful procedure is of paramount importance than the cost involved. A healthy patient is more precious,” Dhir said.