In a first of its kind, the procedure to remove calcium from heart blood vessels was performed at Apollo Hospitals, Chennai using a new technology called Orbital Atherectomy. Orbital Atherectomy is a new procedure that has been introduced in India and Dr Sengottuvelu G, Interventional Cardiologist at Apollo Hospitals, Chennai has successfully performed the procedure in patients with heavily calcified coronary arteries.
One patient among them was an elderly patient who had done bypass surgery 15 years ago and was having chest pain at rest and had a severely calcified tortuous left anterior descending artery. The patient was at high risk for redo coronary artery bypass surgery and the anatomy of his vessels was unsuitable for bypass surgery. He underwent successful ablation of calcium using diamond back Orbital atherectomy device.
“Calcified lesions are difficult, challenging subsets to treat as they are hard and conventional balloon angioplasty does not work. There are several tools available to treat these hard blocks such as rotational atherectomy, intravascular lithotripsy, specialized balloons etc. Rotational atherectomy was the only option available for several years,” explains Dr Sengottuvelu.
He said that orbital atherectomy is a novel therapy used for opening up calcified blocks before stenting. It has a 1.25 mm diamond-coated crown which erodes the calcium into fine particles approximately 2 micron in size (sanding) and creates micro fractures in the calcium. The device can be operated at low and high speeds which is decided based on the anatomy of the patient.
The availability of this device adds another option to treat these calcified blocks. It is particularly helpful in large vessels with long calcified eccentric lesions. The device has a learning curve and the operator needs to be trained. The patient recovered well and is being followed up.
