72 yr old Lady eats without pain after 3years

Mrs. Shanti, a 72 year old lady had a history of stomach pain for the past 3 years. She was admitted with complaints of severe abdominal pain on eating 1year ago. The pain was so extreme, that eating had become a curse for her. She survived on very minimal amounts of semi-solid and liquid food which had made her lose a considerable amount of weight.

She was diagnosed to have (mesenteric ischemia) blockages of the two of the three main blood vessels supplying her intestines.

Considering her age she was treated with medicines for 6 months but her pain persisted and she started passing blood in her stools hence she got admitted at MIOT last month.

She was not fit for surgical treatment due to her age and the need for major high risk surgery to treat it. She was referred to our Interventional Radiologist to see if this could be treated by endovascular procedure.

Endovascular surgery is an innovative, less invasive procedure used to treat problems affecting the blood vessels that involves making a small incision near each hip to access the blood vessels.

Patient had a 10cm long standing hardened blockage of the main Superior Mesenteric Artery (SMA) (Fig. 1 & 2) and the chances of successful reopening were slim. But considering her age, pain intensity and blood loss, MIOT Doctors decided to take her up for the interventional procedure.

The next day she underwent the surgery in the MIOT’s State-of-the art Biplane Cath lab. As the block was in a very complex position, images were taken simultaneously in 2 projections using the 2 C-arm which was crucial to opening the completely blocked blood vessel in this case.  In a machine with a single arm, this would have required the C-arm to be rotated frequently between the 2 required positions, leading to a longer procedure and also the risk of wire getting dislodged from crucial positions when the C-arm is being swung.

Also, with 2 C-arms, only 1 Angiogram is needed as both angulations are captured simultaneously with 1 Contrast dye injection and 1 Radiation exposure, but in conventional Cath lab, 2 Angiograms are needed every time, thus the New Biplane Cath lab reduces the contrast and radiation dose by 50%.

In MIOT’s state-of-the-art Biplane Cath Lab, SMART MASK application overlaps the Angiogram images on live X-ray images, used for live guidance of the catheter.

With the guidance of a SMART MASK application, the interventionist managed to open her blood vessel by slowly crossing the blocked segment (Fig. 3).

As the block was 10cm long, a balloon was inflated to push the plaque towards the walls of the vessels (Fig. 4).

Then a 4cm long stent was placed to keep the vessel open (Fig. 5).

The next day the patient’s pain had resolved and she enjoyed her morning cup of hot tea after a very long time. Slowly semisolid food was introduced and now she is managing it quite well.  She also stopped having blood in the stools.

Watch MIOT Patient Story (procedure performed with Biplane CathLab)