COMPLEX CORONARY ANGIOPLASTIES

Complex angioplasties are technically challenging, take more time to perform, may have lesser success rates, consume more dye/contrast, result in more radiation to the patient and the cathlab personnel, utilize more hardware and are more expensive. The factors that determine the complexity of a procedure could be a) clinical or b) anatomical.

Clinical factors that make an angioplasty complex include elderly patients, patients with other severe diseases of the lungs, kidneys, liver, etc, obese patients, emergency presentations with heart attacks, patients with reduced pumping of the heart/heart failure, sick patients with abnormally low blood pressure and/or abnormal cardiac rhythms, etc.

Anatomical features resulting in complex angioplasty include multiple blockages, long lesions, severe calcifications, blockages of the left main coronary artery, blockages involving bifurcations/trifurcations (branch points), chronic total occlusions, lesions with a lot of blood clots, etc.

Skilled cathlab technicians and nurses with experience in dealing with such complex procedures are a must. Experienced operators and support from anesthetists hold to the key to success in these challenging subset of cardiac patients.