Meenakshi Hospital Thanjavur has performed a novel procedure and an advanced catheter-based technique called ‘Orbital Atherectomy’, on a 78-years old man who had developed hard-to-break, highly calcified coronary plaques.
Since the patient Mr Gurunathan of Karaikal was an elderly person, he was at high risk for redo coronary artery bypass surgery and anatomy of his vessels was unsuitable for bypass surgery. He underwent successful ablation of calcium using the Orbital Atherectomy device before stenting.
Coronary plaques refer to the buildup of fatty substances, cholesterol, cellular debris, and other materials within the walls of the arteries. As a plaque matures and becomes more advanced, calcium deposits can accumulate within it. These calcium deposits cause the plaque to harden and become more stable. Plaques narrow or block arteries and thus reduce blood flow to heart muscles which leads to chest pain and heart attack. Limited intake of cholesterol, fat and sodium, and regular exercise can prevent the formation of plaques and calcification.
Atherectomy is preferred when the coronary plaques are severely calcified and thus become difficult to treat with conventional methods like angioplasty and angioplasty with stent placement. Orbital atherectomy is the most advanced atherectomy technique. The key benefits of this procedure are that its rotational motion provides a unique mechanism for widening the inner space of arteries, while minimising the risk of causing damage to the arterial walls. Orbital atherectomy widens arterial lumen by up to 4 millimetres (mm), surpassing the typical 1.75 mm achieved by other atherectomy techniques such as rotational atherectomy.
Commenting about the introduction of orbital atherectomy, Dr. Ravichandran, Medical Superintendent, Meenakshi Hospital, Thanjavur said, “We are happy to have brought the orbital atherectomy procedure for the benefit of patients in Delta Region. It is one of the latest technologies in interventional cardiology, which will help to remove the most difficult calcium deposits in heart arteries. This technology is a boon for senior citizens particularly those who suffer from heavy calcium deposition in the arteries, high-risk patients, including diabetics, and those with chronic kidney diseases.”
On the mechanism of the procedure, Dr Kesavamoorthy, Senior Consultant & HOD – Cardiology, Meenakshi Hospital, Thanjavur said, “During orbital atherectomy, a catheter with a diamond-coated crown at its tip is advanced to the site of the plaque buildup within the narrowed artery. Once the catheter is positioned, the crown is set into a high-speed rotation, typically at speeds of 60,000 to 200,000 revolutions per minute. The rotation creates centrifugal forces, which cause the diamond-coated crown to gently sand or abrade the plaque as it rotates. This process breaks down the plaque into tiny particles, effectively modifying the plaque and widening the arteries.”.
Dr. Srinivasan, Senior Consultant - Cardiology, Dr. P. Sabari Krishnan, Consultant - Cardiology and Dr. Praveen - Deputy Medical Superintendent were also present at the press conference.