Mumbai: At 55, Ratnesh
Shah was suffering from frequent chest pain and was advised a
coronary angiography -- which involves opening up blocked vessels.
Unfortunately, both his femoral (groin) arteries were closed
because of a vascular disease.
His radial (wrist) arteries were also calcified and had lesser
capacity to bear with an incision, with tests showing that nothing
wider than 1.7 mm could enter the arteries.
Thus, it was difficult for him to undergo angiography, in which a
tube (called sheath) and another smaller tube (catheter), together
measuring at least 2.8 mm, are inserted in the arteries.
It was then that Shah came to know about a new technique called "sheathless"
angiography, which is also less painful.
"Not everyone is in a position to undergo angiography, which can
be painful owing to the size of insertion required in the
arteries," Narayan Gadkar, a doctor from Jupiter Hospital in
Thane, near Mumbai, who started performing the new procedure in
2010, told IANS.
In sheathless angiography, the catheter is directly introduced in
Gadkar, among the pioneers of the technique, has done nearly 400
sheathless angiography tests so far, but the procedure is still
not well known.
"Angiography is a medical imaging technique used to visualise the
inside or lumen of blood vessels and organs of the body with a
particular interest in the arteries, veins and the heart chambers.
A pipe-like object known as sheath is inserted in the arteries,
through which the catheter, 1.8 millimetres ( mm) in diameter, is
inserted," he explains.
"It is a painful experience, specially for Indian patients, as
they have narrow arteries," he added.
"Generally, after puncturing the artery with a wire, we introduce
a sheath, through which we put a catheter, which is painful. But
in the method we use, we put in a catheter without the sheath,
which ensures one millimetre of less invasion," said Gadkar.
"Traditionally, it was done through groin arteries. The puncture
made on the wrist is much smaller than usual," he said.
The puncture on the wrist is also easier than the groin procedure,
which involves complications like immobilisation, Gadkar added.
According to figures released by the World Health Organisation
(WHO), 60 percent of the world's cardio-vascular patients are
expected to be in India by 2016. The country already has more than
100 million heart patients.
With a high number of young adults being affected by heart
problems, angiography is one of the most widely used methods to
diagnose heart problems and blockages at an initial stage.
"People are usually afraid of angiography and they keep on
avoiding it. This results in heart attacks," the doctor adds.
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