How IVUS in balloon angioplasty can be a boon for heart and kidney patients

Balloon angioplasty using IVUS, has proved to be successful on heart patients with kidney ailments and diabetes, for Kerala-based Meditrina Hospital

Ever wondered why heart and kidney diseases often go together? When there's an accident on a highway linking major cities, it's rare that just one road would be affected – a traffic jam on one major route often leads to congestion on others. Similarly, the vital organs are like cities connected by a network of highways and main roads (arteries and veins). When there's a problem in one, things often go wrong elsewhere, too. This is especially true of the heart and kidneys, which work very closely together. A heart disease can often cause chronic kidney disease, and CKD can also cause heart disease.

How kidneys and heart work together

The heart’s job is to send a continuous supply of oxygenated blood around the body. The kidney filters the blood, extracting waste in the form of urine, and also helps regulate the water and salt levels to control blood pressure.

When the heart is no longer pumping efficiently, it becomes congested with blood, causing pressure to build up in the main vein connected to the kidneys, leading to congestion of blood in the kidneys, too. The kidneys also suffer from the reduced supply of oxygenated blood.

When kidneys become impaired, the hormone system, which regulates blood pressure, goes into an overdrive to increase blood supply to the kidneys. The heart then has to pump against higher pressure in the arteries, and eventually suffers from the increase in workload.

What is balloon angioplasty?

Ballon angioplasty is a medical procedure in which, a specially designed catheter with a tiny balloon is carefully guided through the artery to the blockage, then inflated to widen the opening and increase blood flow to the heart. A stent is often placed during the procedure, to keep the artery open after the balloon is deflated and removed.

Demerits of balloon angioplasty

Contrast-induced acute kidney injury (CI-AKI) is an important adverse effect of percutaneous coronary interventions. The contrast used in the balloon surgery to get a clear view of the blood vessels may lead to kidney complications by increasing the creatinine and urea levels in the blood. This may lead to a permanent dialysis stage. Despite various efforts, very few preventive measures have been shown effective in reducing its incidence.

What’s the alternative?

Balloon angioplasty can also be done using Inter Vascular Ultra Sound (IVUS). This has been confirmed by Kerala-based Meditrina Hospital, which has successfully performed balloon angioplasty using IVUS with a 100 per cent success rate.

How does that work?

IVUS helps determine the exact width of blood vessels, the reason for blocks like calcium deposit or blood clot without any postoperative complication. With IVUS, the diagnosis and removal of the blocks happen without the help of contrast. IVUS also helps doctors in selecting stents easily.

Usually, doctors do not recommend balloon surgery for patients who suffer from kidney ailments, diabetes and those who are senior citizens. However, according to Dr Prathap Kumar, chairman & managing director of Meditrina Hospital, balloon surgery using IVUS has shown positive results.