Kauvery Hospital Chennai, a unit of Kauvery Group of Hospitals, a leading multi-specialty healthcare chain in Tamil Nadu, has successfully conducted a complex coronary angioplasty procedure using drug coated balloons (DCB) for a man aged 74. The team of cardiologists performed an image-guided procedure using DCB alone without adding new stents, with excellent outcome. This innovative technique eliminates the side effects of stenting and can be an effective alternative to stents for coronary angioplasty.
The individual visited Kauvery Hospital Chennai with recurrent chest pain and had previously undergone left main bifurcation stenting in 2018 from elsewhere. However, the coronary angiogram showed severe in-stent restenosis of both stents, i.e. re narrowing in the stents placed earlier leading to narrowing of arteries.
Bypass surgery was one option to resolve the condition, but the individual refused to undergo the same. On the other hand, a repeat angioplasty using two more stents in the same site was deemed too risky, as it would result in multiple layers of stent and too much metal in that area, increasing the risk of stent clotting or restenosis.
DCB is a milestone and the fourth revolution in Percutaneous Coronary Intervention (PCI) therapy, after balloon angioplasty (1977), bare metal stents (1988), and coronary drug-eluting stents (2001). Unlike traditional stenting, where a metal stent is permanently inserted to enlarge a blocked artery, DCB releases a drug (Sirolimus) from the balloon surface within 60 seconds of inflation, eliminating the risks associated with stenting.
According to Dr. K.P Suresh Kumar, Chief Cardiologist at Chennai Kauvery Hospital, DCB can replace stent usage in up to 25% of angioplasty procedures. “Today about 95% of angioplasty procedures use a metal stent to enlarge a blocked artery permanently. However, this can create stent related issues and the need to continue multiple blood thinning medicines for at least one year, with the risk of bleeding. Stenting & drug coated balloons are complementary and we can combine both in appropriate patients. We can eliminate all the side-effects of stent and the blood vessels even undergo positive remodeling. It can reduce the stent usage & preserve the normal function of the blood vessels. The concept can be extended to bifurcation stenosis where stenting of the main vessel and DCB to the smaller branches is a viable option. The Sirolimus drug-coated balloon available in India is called MAGIC TOUCH balloon, which has the largest data globally, and the US FDA recently approved this balloon,” he said.
India, being the diabetes capital of the world has a major population with blocks in small caliber vessels and hence inserting a small diameter stent carries a high risk of restenosis. Drug Coated Balloons is best suited for the Indian population. “The technique also helps eliminate the dual antiplatelet therapy after 3-6 months post procedure. We have performed close to 100 procedures with the Drug Coated Balloon and it is proven to be effective in patients with suitable clinical scenarios,” added Dr Suresh.
Prof. Antonio Colombo, Director of Cardiac Cath Lab and Interventional Cardiology at EMO Centro Cuore Columbus in Milan, Italy, and an international pioneer in interventional cardiology, said that special drug-coated balloons are emerging as an alternative to stents in several cases. “This innovative technique has opened new horizons in the field of angioplasty and can help perform metal-less or metal-free angioplasty in appropriate patients,” he added. Prof. Colombo was in Chennai for an interventional cardiology workshop being held at Kauvery Hospital.
Kauvery Hospital is proud to be at the forefront of the adoption of new and tested medical technology to provide reliable, optimum, and suitable healthcare solutions to the masses. “The innovative DCB procedure marks a significant milestone in the field of interventional cardiology, and Kauvery Hospital Chennai is proud to have been a part of this innovation. Cardiology has been a centre of excellence since its inception, and we have successfully treated many patients with complex heart diseases and conditions. We have been in the forefront of adopting to new technologies and infrastructure such as the Hybrid Operating Theatre, Laser Angioplasty, 3D Navigation System and latest being the regular use of Drug Coated Balloons in appropriate patients,” said Dr. Aravindan Selvaraj Co-Founder and Executive Director Kauvery Hospital
