Dr. Gaurav Ganeshwala

Coronary angioplasty also called PCI or PTCA – is a noninvasive procedure that helps treat coronary heart disease [blocked coronary arteries] by improving the blood supply to the heart muscle, through widening and opening of the narrowed coronary arteries. It is used to stop heart attacks in progress, treat chest pain (angina), and restore blood flow through the coronary arteries. The procedure is performed in the cardiac catheterization laboratory (or cath lab) by a specialized Interventional cardiologist.

An angiogram is performed prior to angioplasty. Here, a thin plastic tube is inserted into an artery in the groin or arm. A long, narrow, hollow tube, called a catheter, is passed through the sheath and guided up the blood vessel to the arteries surrounding the heart. A small amount of contrast liquid is injected through the catheter and is photographed with an X-ray as it moves through the heart’s chambers, valves, and major vessels. From the digital pictures of the contrast material, the doctors can tell whether the coronary arteries are narrowed and whether the heart valves are working correctly.

Intravascular imaging has revolutionized the precision of angioplasty. One type of imaging is the Intravascular Ultrasound, where a miniature probe is used to study the nature of the plaque. Where regular angiography shows only a two-dimensional silhouette of the interior of the coronary arteries, IVUS visualizes the coronary artery from the inside out.  This unique point-of-view picture, generated in real-time, yields valuable information.

Yet another innovative method of intravascular imaging is Optical Coherence Tomography [OCT]. This produces high-resolution intracoronary images using infrared light.

The new imaging technologies give crucial information whether the plaque blocking the vessel is hard or soft, is made up of lipids or calcium, etc. They can also give accurate detail about the size of the stent that may be needed, and assess post stenting status of the vessel as well.