When a patient presents with profuse sweating, exhaustion and chest unease, the ground rule in a Cathlab is a balloon angioplasty that will dilate the blocked artery and restore perfusion.
However, cardiologists at Apollo Hospital had to turn to a new stent technology when investigations on a 27-year-old patient revealed that the clot had migrated downward to the smaller branches of the blood vessel.
The team at Apollo used the M Guard stent, a mesh-wrapped standard metal device that prevented further dislodgement of the clot before applying a clearway catheter — another recent introduction — to inject an anti-clotting drug to dissolve the clot. The patient now has a perfectly fine heart and is ready for discharge.
Apollo said this was the first time that the M Guard mesh-stent was being used in Chennai.
“The new stent helped trap the blood clot without further splintering and occlusion of distal branches during deployment,” said G. Sengottuvelu, senior consultant and interventional cardiologist at Apollo.
The patient's condition represented a challenge because of the risks of the clot getting displaced into the lower branches of the blood vessel and impeding distal circulation. The other worst-case scenario is that the clot could get into the aorta, raising the risk of a stroke.
While the ischemic time (the duration from the onset of symptoms to re-perfusion of blood flow in the artery), in the case of this patient was about five-and-a-half hours, the procedure with the M Guard stent could be completed in 20 minutes flat, Dr. Sengottuvelu said.
N. Sathyabhama, Director, Medical Services, Apollo, said the lesser the door-to-balloon time, the lesser the scarring of muscle tissue in the heart and better the treatment outcomes.