How innovations in medical imaging can help detect coronary heart disease, Health News, ET HealthWorld

By Dr. Y. Vijayachandra Reddy

There has been a steady increase in cases of cardiovascular disease (CVD) around the world. According to data from the World Health Organization (WHO), cardiovascular disease is the leading cause of death worldwide, claiming an estimated 17.9 million lives each year. Heart attacks and strokes account for more than four in five CVD deaths, and one-third of these deaths occur before the age of 70.

In India, heart diseases are steadily increasing among the young population. More than 50% of CVD deaths occur in people under 50, making coronary heart disease (CAD) more prevalent among Indians at younger ages. Some of the common risk factors are hypertension, diabetes, smoking, dyslipidemia, and obesity.

Traditionally CAD was usually treated with heart bypass or open heart surgery where the surgeon takes a short length of artery from inside the chest and a vein from the leg and surgically ties it above or below the blocked area of ​​the heart artery, improving heart blood flow. This treatment carried risks such as excessive bleeding, arrhythmias, blood clots and infections.

Thanks to innovations in cardiac care, there are minimally invasive treatment options available today to treat coronary artery disease. Angioplasty with coronary artery stenting is a procedure where a small mesh tube called a stent is implanted into the artery to widen the artery and ensure adequate blood flow. Angioplasty in conjunction with intravascular ultrasound (IVUS) is one of the most popular ways to treat coronary artery disease today.

How do advances in medical technology help with diagnosis and treatment?

As medical technology continues to advance, cardiologists are increasingly recommending cardiac treatments that are less invasive and less likely to cause recurrent cardiac episodes. Thus, the deployment of the stent performed under the guidance of intravascular ultrasound (IVUS) ensures optimal results even in the most complex cases and results in a better outcome for the patient. Several studies conducted around the world also point out that IVUS-guided procedures are more accurate and cost-effective.

With the advancement of next-generation catheters, IVUS imaging has recently seen tremendous improvements. These catheters provide sharper, high-definition imaging of arteries, improving diagnosis and treatment planning.

The advantage of HD IVUS over angiography, which only provides a two-dimensional exterior view, is that it conveys a detailed three-dimensional interior image of each layer of the blood vessel. The highly advanced HD IVUS system works on the principle of ultrasound waves. It includes the catheter, a tube fitted with a special probe or camera at one end which has ultrasonic properties to capture the image of the internal appearance of blood vessels in real time. The other end of the tube is attached to a machine that converts the images captured by the ultrasound mechanism and displays them on a monitor, giving the surgeon a full 360 degree internal view and much greater clarity.

In people at high risk, especially in patients with diabetes, ACS and renal failure, HD IVUS is very beneficial.

How is IVUS different from angiography?

Angiography is a diagnostic procedure that identifies disease in the walls of the coronary arteries. Although IVUS is an imaging technique that allows the doctor to get a detailed look at the heart’s blood vessels from the inside out, studies have shown that HD IVUS-guided PCI is more economical than angio-guided PCI.

Angiography only helps to reveal the narrowing of blood vessels; it does not help provide information about the nature of the blockage or the composition of the plaque. On the other hand, IVUS provides the physician with essential clinical information that helps identify the blockage and select the correct stent size and confirms stent placement to minimize future risk. It is important to understand that IVUS is performed alongside angiography and not as a replacement.

The item is for educational purposes only. Please consult your doctor for a better understanding of your condition.

By Dr. Y. Vijayachandra Reddy, Senior Consultant Interventional Cardiologist, Apollo Heart Institutes

(DISCLAIMER: The views expressed are solely those of the author and ETHealthworld does not necessarily endorse them. shall not be liable for any damage caused to any person/organization directly or indirectly)

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