CHIP Technology
CHIP Technology: Complex Coronary Artery Disease
Complex coronary artery disease (CAD) management may not be feasible nor optimal with standard angioplasty techniques alone. Here are some of the latest technologies used in CVSKL to treat the complexity of coronary heart disease.
Coronary artery disease drug-eluting stents
Stent utilized in CVSKL are clinically proven in many medical studies and are approved devices by major regulatory bodies (for example US FDA, and the European Medicine Agency)
Specialised stent platforms available include:
- A stent that is designed with high strength to scaffold large arteries, with more than 4.00mm vessel size.
- A stent that can restore vessel pulsatility and potentially improve vessel remodelling and plaque stabilisation.
- Resorbable magnesium scaffold where 95% of the stent material will be resorbed in 12 months.
Photos: There are a variety of stent platforms to accommodate your coronary vessel.
Balloon angioplasty
Balloon angioplasty is used to prepare a lesion before stent placement and to optimise the stenting results. In some cases, medicine-coated balloons are used as the final treatment for the disease.
Some of our featured balloons:
- Cutting and scoring balloons to treat resistant and calcified lesions
- High-pressure and ultra-high-pressure balloons for highly calcified, resistant, and under-expanded stent lesions
- Drug-coated balloon designed to treat restenosis and small vessel disease.
Invasive Coronary Imaging
Modern coronary angioplasty with adjunctive use of intravascular imaging-guided treatment and improves results and patient outcomes. The modalities available in CVSKL include:
- High-definition intravascular Ultrasound (HD-IVUS)
- Optical coherence tomography (OCT)
Coronary Physiology Assessment
Measurement of flow and flow-derived parameters in the coronary artery has been proven to guide decision-making for angioplasty and to assess the adequacy of treatment.
Physicians can target treatment only to the flow-limiting heart blockages that are important to improve patient’s symptoms and outcomes. This assessment may be performed via two available modalities:
- Fractional Flow Reserve (FFR): Invasive coronary pressure wire and sensor to measure flow in the arteries during the catheterization procedure, and using Adenosine (pharmacology agent) to assess the flow.
- Quantitative Fractional Reserve (QFR): Non-invasive functional assessment of coronary narrowing derived from the coronary angiographic images.
Coronary Calcium Modification Technologies
The presence of significant coronary artery calcification complicates the angioplasty procedure. It may hinder stent delivery, and stent expansion, and lead to a higher chance of complications. The calcium component of the plaque needs to be modified to facilitate the angioplasty procedure, reduce complications, and improve long-term outcomes.
The technologies available to modify coronary calcium in CVSKL include:
- Rotational Atherectomy (Rotablator)
- Orbital Atherectomy (OAS)
- Intravascular lithotripsy (IVL)
- Ultra-high-pressure balloons (e.g., OPN balloon)
Mechanical Circulatory Support (MCS)
Performance of complex angioplasty especially in a patient with a poor heart function is highly risky with the possibility of cardiac arrest during the procedure. For this reason, Mechanical Circulatory Support (MCS) devices can be used to support heart function.
There are two types of MCS devices used in CVSKL:
- Intra-aortic balloon pump (IABP) – which provides heart function support.
- Impella® device – which is one of the technologies available today for optimal support during high-risk angioplasty procedures.
With these technologies, some of the most high-risk patients who are unfit to undergo surgical treatment may be offered mechanical circulatory-supported angioplasty treatment options and a complete revascularization could also be performed.
Related videos
Throughout the broadcast, our doctors shared their extensive knowledge and experience to the participants in Bangladesh. The procedure was successfully executed, showcasing the utilisation of an advanced imaging technique called Optical Coherence Tomography (OCT) Imaging. This innovative approach optimises the management and long-term outcomes of complex percutaneous coronary interventions.
Here in CVSKL, we take pride in our role as advocates for ongoing learning, ensuring that the latest advancements and knowledge in cardiovascular care are shared and accessible to healthcare professionals around the world.