India’s second Shock wave intravascular lithotripsy performed in record time of 35 minutes at Saroj cardiac sciences – Indian Spinal Injury Centre, Vasant Kunj, New Delhi. 

New Delhi: An 80-year-old Male patient with severely limiting angina and 90% stenosis in the LAD coronary artery was successfully treated with the latest Shock wave intravascular lithotripsy (IVL) in a record time of 35 minutes at Saroj cardiac sciences – Indian Spinal Injury Centre, Vasant Kunj, New Delhi. Shock wave intravascular lithotripsy (IVL) is the latest technology, recently launched in India and this is only the second case to be successfully treated in Delhi.

“This device delivers localised pulsatile high-speed sonic pressure waves which pass through the soft tissue and selectively disrupt calcium. Disruption of calcium facilitates the delivery, expansion and apposition of the scent to vessel wall resulting in good procedural outcomes. The procedure time in our patient was just 35 minutes and the patient could be discharged the next day of procedure in stable condition.” Says Dr. Aseem Dhall, Director and Head Cardiology Department, Saroj cardiac sciences- Indian Spinal Injury Centre, Vasant Kunj, New Delhi

Shockwave Intravascular Lithotripsy is a novel procedure which brings hope for those suffering from an advanced form of coronary artery disease (CAD) having angina or heart attack in which the blockage becomes very hard due to deposit of calcium. This happens in 20-25% of the patients undergoing angioplasty and stenting especially those who are old, diabetic, have chronic kidney disease, have long standing blockages or who have undergone previous bypass surgery. This technique is a major advancement over the previous techniques used for such hard blockages like ultra-high-pressure balloons or rotatory drills which are difficult to use and carry risk of rupturing the artery.

While the traditional methods have been in use to cut calcium like cutting balloons, high pressure balloons and rotational coronary atherectomy, but they pose a risk of complications and may lead to extensive vessel dissection, rupture or even perforation of coronary arteries which may be fatal for the patient. Also, these methods are ineffective in dealing with eccentric and deep calcifications.

Percutaneous coronary interventions (PCI) of calcified coronary arteries continues to be one of the most challenging interventions in the field of cardiology. These calcified and rock-hard lesions are associated with difficulties in delivery of balloon and stem, impaired stent expansion and apposition, resulting in adverse procedural outcomes.We always remain at the forefront of bringing cutting edge technology for better clinical results. This is yet another opportunity when our world class team of cardiologists applied a novel technique to improve upon success rate of a stenting procedure. This is going to provide much credible patient experience post treatment. Our patient experience remains our core objective and such events help us move towards achieving greater heights in this regard” said Dr Bhardwaj, Director, Saroj Group of Hospitals.

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Bengaluru : Calcification of coronary artery plaques poses unique challenges in treatment with angioplasty and stent. Hard calcified blockages do not yield easily to balloon and therefore the stent doesn’t expand well. This effect long term outcomes of angioplasty. Various methods have been hitherto available to deal with this situation, such as rotablation , very high pressure balloons , atherectomy devices etc. A very recent addition to the armamentarium is Shockwave lithotripsy also called intravascular lithotripsy, which uses a special balloon to deliver high pressure waves at the blockage and breaks the calcium. This softens the blockage and facilitates successful angioplasty and stenting.

Sakra World Hospital, one of the city’s leading multispecialty hospital, performed Karnataka’s first Coronary Shockwave Lithotripsy surgery recently. This surgery was carried out by Dr Sreekanth B Shetty, Senior Consultant and Head of Interventional Cardiology, Sakra World Hospital on  a 75-year-old patient suffering from an advanced form of Coronary Artery Disease (CAD) with multiple blockages which turn hard due to calcification.

The patient came with a resistant heart failure and had multiple artery blockages with calcium deposits along with other underlying health conditions because of which he could not undergo bypass surgery. He was treated with a combination of Rotablation and Shockwave lithotripsy. This innovative technology was launched by Shockwave Medical, USA, and was introduced in India very recently after being approved by the Drug Controller General of India (DCGI).

Commenting on the procedure and the technology, Dr Sreekanth B Shetty says,“Sakra World Hospital has always been the forefront of adopting new technology and provide world-class clinical medical services to its patients. We are glad to be the first hospital in Karnataka to conduct Shockwave Intravascular Lithotripsy. This innovation will benefit numerous patients undergoing angioplasties. Over time, coronary blockage becomes hard which leads to deposition of calcium. Often these blockages do not let the conventional balloons to dilate the lesion leading to unsatisfactory results in angioplasties performed. Also, under expanded stents carry high risks such as stent clot formation which causes a 30-40% mortality rate and also of restenosis. However, with this novel technology, we can easily open up calcified plaques safely in carefully selected cases.”

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