Coronary angioplasty evolved

considerably over the decades. However imaging during angioplasty has not kept pace. In India, 95% of the time, conventional angiography is still used as guidance.Angiography has its own limitations as it only visualises the lumen (the cavity filled with blood) of the arteries and not the arterial wall. Ideally, the Interventional Cardiologist should be able to see both.

The advent of OCT

Optical Coherence Tomography (OCT) is a novel technique that’s superior to angiography. OCT is a simple procedure which can be performed during angioplasty using a special catheter. It has a light source which helps in visualizing the inside of the arteries which cannot be seen through angiography. The arterial wall can be visualised using contrast injection and clear, high definition images of the artery and any cholesterol plaque can be obtained.

How does it benefit you?

  • OCT assists in optimization of stenting in angioplasty, helping them last longer.
  • OCT helps Interventional Cardiologists visualize the inside of coronary arteries, the severity of blockages and the type of plaque clogging the arteries. This clarity helps them perform complex coronary angioplasties with confidence and obtain results comparable to bypass surgery. MIOT is the first Center in Tamil Nadu and only the third Center in India to acquire this guidance system.

OCT in action

OCT is most helpful in patients with re-narrowing of stents where the cause for re-narrowing can be identified and can be fixed with balloon angioplasty or further stenting.

This was put to the test recently when a 73 year old man visited the hospital complaining of chest pain. In 2006 he had undergone an angioplasty using one of the early metal stents. Unfortunately, because of his diabetes and other medical problems, the stent had re-narrowed. OCT revealed that tissue was growing within the stent and almost blocking the stent. This may not have been revealed in a regular angiogram. Using OCT guidance the cardiac team were able to perform a complex procedure introducing the latest Drug Eluting Stent within the old stent, which would safeguard against renarrowing, successfully.

Dr. Amal A. Louis
MBBS, MRCP (UK), CCST (Cardio) – UK
Interventional Cardiologist
MIOT Heart Revive Center

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