Meril
Heart disease, once predominantly observed in urban areas and older populations, is now increasingly affecting rural regions and younger individuals, transcending age and geographic boundaries. This alarming trend underscores the need for advanced and accessible treatment options. Among these, metal-less angioplasty, which utilizes drug-coated balloons and BioResorbable scaffolds, is emerging as a ground-breaking alternative to traditional metal stents. These novel technologies offer significant benefits, including reduced risk of long-term complications and enhanced natural healing of the arteries. As these innovative treatments become more widely available, they are being adopted globally, providing hope and improved outcomes for patients regardless of their location or age.
Dr. Anuj Bhasin, Interventional Cardiologist, Icon Hospital
Coronary Artery Disease: Coronary Artery Disease (CAD), also known as heart disease or ischemic heart disease (IHD), is a severe cardiac condition that occurs due to the narrowing of the coronary arteries. This narrowing of the arteries happens due to the gradual deposition of plaque, a combination of cholesterol, fatty substances, and calcium among other deposits on the inner walls of the arteries. This plaque accumulation constricts the normal flow of oxygen-rich blood to the heart, thereby, increasing the risk of a heart attack.
Dr. Anupam Shah, Interventional Cardiologist, Ashwini Hospital
The India Story:
Cause and Symptoms of Coronary Artery Disease: Modern Lifestyle, stress, and tobacco use are the main reasons for the high occurrence of coronary artery disease among young Indians. Dietary habits, processed foods, sedentary lifestyles, and alcohol consumption also exacerbate the risk of CAD.
Chest pain, radiating pain to the shoulders, arms, neck, jaw, or back, shortness of breath, fatigue, Palpitations, sweating, nausea, and dizziness are signs of coronary artery disease that can lead to a heart attack. If any of the symptoms are experienced, immediate medical intervention is required to avoid fatality.
Lifestyle Modifications: Lifestyle modifications play a huge role in managing heart health. A whole diet, regular physical activity, stress management, and smoking cessation along with prescribed medication can help to maintain and improve heart health.
Treatment Options for Coronary Artery Disease: Angioplasty and Coronary Artery Bypass Grafting (CABG), commonly known as bypass surgery, are two common treatment options for Coronary Artery Disease.
In open-heart bypass surgery, a new route for blood flow is created around the blocked artery to regulate the flow of blood to the heart. This is an invasive process and requires a long-term hospitalization and recovery period.
Angioplasty, also known as Percutaneous Coronary Intervention (PCI), is a minimally invasive procedure and a preferred treatment option for patients with co-morbidities and other age-related complications who are considered high risk for surgical procedures.
Angioplasty: Angioplasty is a minimally invasive procedure to widen the blocked artery and restore normal blood flow to the heart. During this procedure, a thin, flexible tube called a 'catheter' is inserted through the groin and guided to the blocked coronary artery. Once positioned, a small balloon catheter is inflated to compress the plaque against the artery walls. This balloon catheter widens the artery to restore blood flow. A metal or a BioResorbable âstent' is then placed and expanded at the blocked site to keep the artery open, even after the balloon is deflated and removed from the body.
Angioplasty is performed in a Cath lab with modern technical equipment and patients are usually discharged within the same day or up to 48 hours after the procedure.
Metal-Less Angioplasty with BioResorbable Scaffolds (BRS) and Drug Coated Balloons (DCB): Metal-less Angioplasty is one of the most advanced treatment options for CAD as it negates the need for a permanent metallic stent in the blocked arterial site even after optimal utilization.
"Metal stents are permanent fixtures in the body and can pose risks of metallic allergy and cause hindrance for any future intervention if required in the same artery. BioResorbable Scaffolds (BRS), on the other hand, are made up of biodegradable polymers that initially provide scaffold support just like metal stents and gradually dissolve over time and allow the artery to heal and function naturally. With the increasing number of youngsters at risk for CAD, BRS is highly recommended for them," informs Dr. Anuj Bhasin, Interventional Cardiologist, Icon Hospital, Dombivali, Thane. As BRS dissolves, it is replaced by natural tissue and this process considerably reduces the risk probability of long-term complications.
"In metal-less angioplasty, another approach is using a Drug Coated Balloon, in which the Balloon is coated with anti-proliferative medications such as Paclitaxel or Sirolimus. These drugs stop the overgrowth of smooth muscle cells that can cause the artery to narrow again (restenosis) after the angioplasty procedure. Drug Coated Balloon (DCB) has been a key innovation in treating CAD," explains Dr. Anupam Shah, Interventional Cardiologist, Ashwini Hospital, Solapur. Novel technologies like Metal Less PCI and Drug Coated Balloons are now available even in Solapur. Using a DCB with a metal-less approach provides significant benefits by keeping arteries in a natural state and making future interventions easier, especially as there is a high probability that youngsters may need to undergo the same due to their lifestyle.
Links: https://www.sciencedirect.com/science/article/abs/pii/S0377123719301339
https://www.cminj.com/blog/whats-behind-the-rise-in-heart-attacks-among-young-people
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796644/
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