KOCHI: Angioplasty is a procedure done in people who have coronary artery disease or suffered a heart. It has become a common life-saving procedure and evolved over the years to make it safer and improve success rates. Laser angioplasty is the latest technique, which can also treat tough blocks and clear blocks in stents.
Laser angioplasty or ELCA (excimer laser coronary atherectomy) was introduced in the 1980s to manage arterial lesions that could not be managed with conventional methods. "Though the principle was introduced decades ago, it was less popular due to the cost and technical factors. Later, the technology became more useful when ELCA and newer catheters were introduced, ensuring both success and safety," said Dr Sajan Ahmad, head of cardiology at Lifeline Heart Institute, Adoor, Pathanamthitta, Kerala.
When the method was initially introduced, complication rates were high since the technology had not advanced and only few patients benefitted.
“The technology which was launched some 20 to 30 years ago is evolving. The laser rays should not go out of the blood vessels, but in the initial days, such problems used to occur. Now, with excimer laser technology, we use a catheter of one-millimetre diameter. Thus the complication rate will be extremely low. Recent studies show only less than 1% complication. The penetration power is only 50 microns. So, it’s very safe. It is the highlight of the newer laser technology," said Dr Deepak Davidson, chief interventional cardiologist at Caritas Hospital, Kottayam.
The cost of laser angioplasty is almost the double of conventional angioplasty, which deters patients from choosing this option. "The cost of angioplasty is around `1 lakh. For laser angioplasty, the cost may increase by another `1 lakh. Thus, there are chances of patients not opting for it," said Dr Deepak. "Not every heart patient requires laser treatment. Some people who suffer from heart attack may have cholesterol as well as clots. But youngsters will mostly have clots. If the person has clots alone inside the blood vessel and no cholesterol deposits, this technology can be used. It is more helpful for youngsters, as we can vaporise the clots," added Dr Deepak.
"Laser angioplasty system is especially useful in treating recurring blocks inside stents (ISR or in-stent restenosis) in patients who have previously undergone angioplasty. It is also useful in situations where there are tough blocks that cannot be opened using usual angioplasty hardware and in heart attack patients with a heavy load of thrombus or blood clots inside the arteries," said Dr Sajan.
"In elderly patients, we can remove the calcium using a laser without complication. Also, it can be used when there is a block inside previously implanted stents. This is the best technology available in the world to remove blocks in stents implanted many years ago," said Dr Deepak.
The recovery time is also less as the patient can leave the hospital on the third day after the procedure. "If the condition is not complicated with few symptoms, the patient will be discharged on the third day. If the condition of the patient is severe or the heart pumping function is low, they might need more hospital stay. It differs from case to case," added Dr Deepak.