New techniques in the treatment of coronary artery blockage
1. atherectomy2. rotational ablation3. laser balloon angioplasty
Atherectomy: This is the process of extraction of the cholesterol rich plague or blockage from the coronary artery. This is also introduced inside body through the groin and it also looks like a balloon catheter. The blockages are cut into pieces and are stored inside a small housing. The conventional balloon PTCA can not reduce the bulk of the blockage but only compress it. During atherectomy the bulk of the atheroma can be reduced, so it is a debulking procedure. There is cutting blade at the tip of the catheter and it spins at a rate 5000 rpm inside the coronary artery. Though this type of treatment can reduce the size of the blockage more effectively and produce lumen diameters better than PTCA but these new techniques have not reduced the rates of acute complications or restenosis after coronary angioplasty.
Rotational ablation: This is another approach for removing atheromatous plaque from the narrowed coronary arteries. It looks like a burr and the whole process can be compared with burring usually performed by the carpenters. This technique uses a diamond studded burr spinning at about 180000 rpm to excavate the obstruction. Though burring is associated with higher short-term success but the rates of restenosis is higher in burring patient compared to conventional PTCA.
Laser balloon angioplasty: the present technique involve the application of a continuous wave neodymium, yttrium laser irradiation transmitted through a fiberoptic system that heats up the culprit obstruction. Argon laser, Holmium laser are also used to reduce the blockage. This technique did not gain popularity as long term results are disappointing.
