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India has seen great technological advancement in the past few decades, these advancements could be subjected to every field but major contribution has been made in medical sciences due to the ever-increasing demand of support and easier treatment procedures. Rotablation is one of such technologies which have contributed immensely in aiding the professionals as a better and safer solution for heart issues such as artery blockages in case of coronary artery disease. Let us understand what causes blockage and how rotablation helps in distressing the heart artery.

What is coronary artery disease?

Coronary artery disease is a heart disease that occurs in major arteries when they get blocked because of plaque build-up. This plaque accumulation ends up restricting the supply of blood and oxygen to the heart. And because there is less space for oxygen and blood to travel through, the heart starts pumping faster which puts a lot of strain on the heart and may also lead to other health-related issues.

What is Plaque?

Plaque is accumulated cholesterol (bad cholesterol) which gets collected in the arteries with time and unhealthy lifestyle leading to decreased blood flow causing chest pain.

What is High-end blockage in the heart?

Blockage in the heart does not happen in a day. You may not notice symptoms for many years and by the time you get diagnosed for it; you already reach severe condition which needs surgical intervention. A high-end blockage is narrowing of the coronary arteries so much that the electrical signals stop.

What is rotablation?

Rotablation is answer to heavily calcified coronary artery disease. Balloon angioplasty is used to deal with calcified arteries but in the case of the highly calcified and narrow artery when a balloon cannot pass through it, rotablation is adopted. The wire used for rotablation is very fine and has a very small circumference which makes it easier to pass through the artery.

How is it done?

Rotablation is a relatively less used and rare procedure in which an acorn-shaped, diamond headed catcher is inserted along with thin wire into the artery up to the point where narrowing starts. The tip of the catcher has a tiny drill and works through air compression. The diamond tip spins at a very high speed which eventually dissolves away all the plague on the artery wall, the microscopic particles thus removed are washed away in the bloodstream. Once rotablation is performed, balloon angioplasty can be initiated in case of need.

The drill used for dissolving the calcified plague can be noisy but it is painless. Patients are not given full anaesthesia. Patients remain awake and conscious throughout the process. The other procedures more common compared to rotablation are stenting and balloon angioplasty.

When is rotablation needed?

Rotablation is needed when one needs to treat heavy calcifications and it is not possible to perform a simple surgery or balloon angioplasty because of the heavy build-up.

Are there any complications associated with this procedure?

Risks and complications are always there when it comes to any procedure depending on how complex the procedure is. Rotablation is a very demanding and technically complex procedure. One has to be really careful while performing this procedure as this requires a lot of attention and complications may arise even after taking all safety measures.

Some of the complications that are associated with this procedure are mentioned below:

  • Peri-procedural myocardial infarction: one might be at the risk of having an MI (myocardial infarction), a heart attack, in simple terms during this procedure. However, the chances of heart problems escalating and leading to other health issues are even higher if one does not get this treatment. MI particularly happens when a part of the heart does not get sufficient oxygen.
  • Stroke: one is at the risk of having a stroke while getting rotablation. However, if one does not get the rotablation done, the risks of stroke and other heart-related problems are even higher.
  • Vascular access complications: one is also at the risk of vascular access complications like thrombosis, infection, bleeding, increased venous pressure, arterial insufficiency, aneurysm, carpal tunnel syndrome, distal ischemia and in fact heart failure during this procedure.
  • Coronary dissection: one is at the risk of getting a coronary artery dissection, i.e., a tear in the artery in the heart during this procedure.
  • Abrupt vessel closure: abrupt vessel closure may also occur during this procedure.
  • Perforation: there is a high chance of perforation as well.

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