What to know about intravascular ultrasound imaging system for diagnosis of heart diseases

Dr Rahul Gupta

What happens when there is a huge rock on a narrow road? It hinders the flow of the traffic causing a blockage. Now imagine the arteries as the narrow road through which blood is supplied from the heart to the rest of the body. If the blood is hindered due to fat or calcium deposits, it might lead to blockage. This blockage can conclude into a heart attack.

Together, heart diseases and strokes account for 17.7 million deaths, across the globe1. According to the World Health Organization (WHO), India accounts for one-fifth of these deaths worldwide, especially in the younger population. As per the National Crime Records Bureau (NCRB), the percentage of people who died from a heart attack in 2019 saw a 53% increase from the previous year. It’s important to understand the disease, reasons and remedies for early diagnosis and treatment.

Coronary Artery Disease

While there might be several reasons for heart attack or failure, coronary artery disease (CAD) is the most common reason. CAD refers to the blockage/ narrowing of the arteries in the heart. This blockage or narrowing is caused by the buildup of fat or calcium deposits, also called the plaque. This causes a significant reduction in the blood flow and people experience mild to severe chest pain or pressure. If the arteries are completely blocked it may result in a heart attack. However, medical advances have improved the treatments allowing CAD patients to return to a normal lifestyle.

Treatment options for CAD:

Different treatments are recommended to the patients by the cardiologist based on their medical conditions.

Medication – Some patients are prescribed medications that relieves the chest pain and discomfort caused by the blockage in the artery. However, this does not treat the blockage. Several other medications are recommended that helps in lowering cholesterol and can also be prescribed by the cardiologist, as they are blood thinners. These medications can only help in preventing blockage of the arteries, keeping the contractions and rhythm of the heart as normal as possible.

Coronary Artery Bypass Graft Surgery – Commonly known as heart bypass or open-heart surgery is another treatment for CAD. The surgeon takes a short length of the artery from the inner chest and vein from the leg and surgically attaches it above or below the blocked area of the heart artery, improving the blood flow to the heart. However, bypass surgery carries risks like excessive bleeding, arrhythmia, blood clots, and infection. It may also cause kidney failure.

Angioplasty with Coronary Artery Stenting – Under this procedure a small mesh tube, called the stent, is implanted into the artery to widen the artery and ensures adequate blood flow to the heart. The stent is left in the artery to keep it open and help in preventing further narrowing of the artery. Angioplasty is one of the most popular ways to treat CAD. However, it is important to note that this treatment is only suggested after getting diagnosed through – Coronary Angiography and Intravascular Ultrasound (IVUS).

Please consult a doctor or other qualified health care professional regarding any questions you have about your health or before making any treatment decisions

How is IVUS different from Angiography?

Angiography is a diagnostic procedure that identifies the disease in the walls of coronary arteries. IVUS is an imaging technique which allows the doctor to have a detailed look into the blood vessels of the heart, from inside out. Hence, angiography provides a two-dimensional image and IVUS offers a three-dimensional detailed image of all the layers of the blood vessels.

The highly advanced HD IVUS system works on the principle of ultrasound waves. It comprises the catheter, a tube equipped with a special probe or camera at one end which has ultrasound properties to capture the image of the inner aspect of blood vessels on a real-time basis. The other end of the tube is attached to a machine which converts the image captured through the ultrasound mechanism and displays them on a monitor, offering the surgeon a complete 360-degree internal view and far greater clarity.

While Angiography shows the narrowing of the blood vessel, it does not help in providing any information about the nature of the blockage or the composition of the plaque. IVUS on the other hand, provides the doctor with critical clinical information which helps in identifying the blockage and choosing the appropriate treatment plan. It also enables one to choose the right size of the stent and confirms the stent placement to minimize the future risks. It is important to note that IVUS is done in conjunction with angiography and not as its replacement.

(The author is Senior Interventional Cardiologist, Apollo Hospital, Belapur, Navi Mumbai.The article is for informational purposes only. Please consult health experts and medical professionals before starting any therapy or medication. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)