Its the era of miniaturization ... and medicine too follows the times. Minimal invasiveness is the watch-word. The rapidity of developments in catheter delivered treatment methods for coronary artery disease is truly mind-boggling.
Why don't you judge for yourself ?
Literally, angioplasty means "fixing" an artery. In heart disease, it is used to describe a method to repair, or dilate, narrowed coronary arteries in a non-surgical minimally invasive manner.
The procedure - called PTCA for Percutaneous Transluminal Coronary Angioplasty - was introduced in the 1980s by Dr.Andreas Gruentzig. It has rapidly evolved, until today, multiple modifications allow usage of PTCA for almost all coronary artery narrowings.
In this technique, through a simple needle stick, a tube called a catheter is passed into a groin artery and guided to the heart. A small balloon is threaded over this catheter into the narrowed coronary artery and the balloon is inflated. The area of narrowing is dilated, thus restoring normal blood flow through it. Sounds simple, isn't it ? In fact, as the procedure is performed under local anesthesia, the patient can actually observe the entire process on the video monitor....if indeed he or she is so inclined !
Certain conditions prevented simple balloon dilation. For instance, some arteries were so narrow that the balloon could not be passed across it. Guess what the "tube-pushers" did next....Give up ? No way...They decided to cut or grind their way through !
Tiny metal drills were fitted onto the tip of catheters. When they reach the area of severe narrowing, these drills rotate at extremely high speeds. They abrade the plaque, and create a channel through which a balloon can then be passed.
Alternatively, using laser energy transmitted to the tip of a catheter, a trail can be cut through the toughest plaque. A balloon can then pass easily. Technology really is marvelous !
Of course, there is the risk of cutting right through the artery wall, and that could be catastrophic. "Smart" lasers have been invented, which actually measure the depth of the artery wall, and stop before they actually puncture the wall !
Anything achieved is necessarily at a price. Since severely blocked arteries were now being opened up using drills and lasers, new difficulties arose.
The artery which was drilled through had a tendency to suddenly collapse and get totally occluded as soon as the balloon was removed. And such a situation is obviously dangerous, as blood supply to the heart is suddenly cut-off, resulting in a heart attack.
What to do then ? See the latest...Click here
WHEW !
That's about all I could find to say about the exciting field of interventions in preventing coronary artery disease. The future in this field seems exceedingly promising, and I am happy to be existing in such a thrilling era. Who knows, a time may when we may no longer have to fear having coronary artery disease...BUT I DOUBT THAT !!