SRINAGAR: For the first time, Orbital Atherectomy and Orbital Lithotripsy procedures were performed at the Super Specialty Hospital Jammu on Tuesday. A doctor who was part of the team performing the procedures said that a 75-year-old patient from Nowshera Rajouri, who had suffered a major heart attack a couple of days ago, was referred from a private center to Government Medical College Jammu. The patient’s angiography, which was done at the same peripheral center, revealed massively calcified critical distal LMCA disease, which is a death sentence if not treated in time.
The doctor said that the treatment of left main coronary artery disease with massive calcification usually requires bypass surgery, but this patient was not willing and wanted an alternative therapy. “The clinical profile and angiography results of this patient were a goosebump feeling, but the patient had to be saved,” the doctor said.
After careful analysis, intravascular ultrasound (IVUS)-guided percutaneous transluminal coronary angioplasty (PTCA)/STENTING was successfully done with satisfactory results with the help of Orbital Atherectomy and intravascular lithotripsy (IVL).
The doctor said that once somebody has severe calcification in their coronary arteries, the stents either do not cross or may not open properly, which can be detrimental both in the short and long term. “Hence, these patients require some form of calcium modulation therapy, and the oldest form of calcium modulation therapy is rotablation, which might fall short in vessels with larger diameter and calcium nodules,” he said.
The newer forms of therapy are intravascular lithotripsy and orbital atherectomy, which, if used in combination, can prove to be a game-changer at times, he said. This patient had large vessels, and the calcium was nodular; therefore, they used the combination of Orbital Atherectomy and IVL, which gave a result beyond imagination, the doctor said further.
“Orbital Atherectomy, with the help of a diamond burr, ablates the calcium into fine particles and creates micro-fractures in the calcium, while IVL sends shock waves and creates fractures in calcium,” he added. (KNO)