A 56-year-old man waitlisted for liver transplant underwent a life-saving procedure in a city hospital. He was treated with a coronary laser atherectomy and angioplasty using a drug-eluting balloon procedure in Kauvery Hospital here recently.
R. Anantharaman, senior consultant intervention cardiologist in Kauvery Hospital, said the patient had undergone angioplasty and stenting of the left anterior descending coronary artery (it supplies oxygenated blood to the muscles of the left ventricle of the heart) in 2006 and when it failed a coronary artery bypass surgery was done in 2010 for all three blood vessels of the heart.
Recently, he was diagnosed with liver failure and advised liver transplantation.
When he went for pre-transplant evaluation, the stent had narrowed down and the bypass graft was not functioning. He was advised to undergo angioplasty and another stenting.
“Patients who have liver failure have a very high risk of bleeding. Another angioplasty and stenting will require the patient to take blood thinner medications which increase the risk of bleeding. Also, he has to continue the medication for a certain period which would delay the liver transplant by several months,” Dr. Anantharaman said.
The doctor’s team decided to treat him with intravascular ultrasound imaging with which it found that the implanted stent was small for the artery. The team performed an IVUS image-guided excimer coronary laser atherectomy procedure to ablate the tissue inside the stent.
A drug eluting balloon procedure was done to dilate the stent and restore the diameter of the lumen to its original status. It was designed to deliver drug into the stent to reduce chances of its narrowing again. The patient would have to take blood thinner medications for a month and it would be stopped before liver transplant, the doctor explained.
Hospital co-founder and executive director Aravindan Selvaraj said the medical procedure was probably the first of its kind in the country. He congratulated Dr. Anantharaman and his team for the feat.