NewZNew (S A S Nagar) : To treat highly complex 100 % blockage of the arteries which have remained blocked for over 100 days without resorting to the elaborate Coronary Artery Bypass surgery, is a stiff challenge for cardiologists. World renowned cardiologist Dr Jiro Ando, MD, from The University of Tokyo Hospital Japan, considered an expert in the treatment of this condition (medical term Chronic Total Occlusion – CTO), conducted a workshop on the subject with Dr Rakesh Kumar Jaswal, Director, Cardiology, Fortis Hospital Mohali, on the hospital premises.
Aimed at improving the skill and expertise level of cardiologists in this particular advanced field of cardiac intervention, Dr Jaswal said. “CTOs are very complicated to treat as there is no space to cross with a wire and deploy a stent in it. Unless a doctor is highly skilled and utilizes CTO-dedicated hardware, success rate can be very low.”
Dr Jaswal further said: “In case the cardiologist is unable to successfully treat a CTO, the patient has to undergo the more elaborate Coronary Artery Bypass surgery. Patients with CTO constitute 20% of all cardiac patients,” he added.
Sharing his experiences with the cardiologists, Dr Ando said, “We’ve observed that if performed successfully, these interventions offer the patients a safer and simpler option of treating their complex coronary disease. This further leads to very high quality and longevity of life.”
Stressing upon the importance of continually organizing such workshops with world-renowned faculty, Dr Jaswal said, “We need to have expertise and skill sets beyond the ordinary to offer highly specialized treatment modality to patients. In February, Dr Ferenc Miroslaw from Germany, an expert in the technically challenging Bifurcation Stenting, had visited Fortis Mohali for a workshop.”
Dr Jaswal informed that treatment options for CTO have traditionally been limited due to the complexity of opening up completely blocked arteries using catheter-based techniques. Historically, physicians have often been recommending coronary artery bypass grafting (CABG), or open-heart surgery, as the only option for treating these blockages. Some patients, however, may not be candidates for CABG surgery due to high surgical risk. New technologies and advanced training have enabled cardiologists to offer minimally invasive methods for treating CTOs with success rates approaching nearly 90%, which gives patients a hope for better quality life, he added.
Performing these CTOs with Radial (wrist) approach are even more difficult and is an art which very few doctors have. Doctors like Dr Ando from Japan do 100% CTO with Radial approach. Dr Jaswal was also among the first to start doing cases Radially and has done maximum cases in Fortis with this approach.
Symptoms for Individuals with CTOs:
- Chest pain, pressure or tightness (angina pectoris)
- Shortness of breath
- Pain in the upper body and arm
- Rapid or irregular heartbeat