Chennai: Apollo Speciality Hospitals, Vanagaram, India’s premier healthcare service
provider organized a workshop on Imaging-Guided Precision Angioplasty using IVUS
(Intravascular Ultrasound) and OCT (Optical Coherence Tomography) in the presence
of world renowned Cardiologist Dr. IMAD SHEIBAN, Director, Interventional
Cardiology, Pederzoli Hospital, Italy at Apollo Speciality Hospitals Vanagaram, today.

The workshop was organized to create more awareness on the technical know-how of
this technology which benefits the patients helps the Cardiologists to perfect the
procedure. Over 100 practitioners in the field of interventional cardiology attended the
one day workshop. Advance techniques in Interventional Cardiology like imaging-guided
precision angioplasty using IVUS and OCT were discussed during the workshop.
The workshop was conducted by leading faculty Dr Imad Sheiban Director,
Interventional Cardiology, Pederzoli Hospital, University of Turin, Verona, Italy, along
with Dr. Anand Gnanaraj, Senior Interventional Cardiologist, Apollo Speciality Hospitals,
Vanagaram .This workshop was organized to keep abreast with the latest in
interventional cardiology particularly in field of Imaging Guided precision angioplasty
and complex cardiac intervention.

Cardiovascular diseases amounts to a staggering 31% of all deaths worldwide, it is
estimated that 7.5 million people die each year in India of cardiovascular diseases.
Moreover, 74% of urban Indians are at risk of cardiovascular diseases. A heart attack
can occur in a coronary artery that looks completely normal on angiography, but the
latest advancements like intravascular ultrasound and OCT reveals the ultimate and
precise cause of the incident. The blocked coronary artery may look completely normal
using the standard two-dimensional "shadow" imaging angiography. But when the same
segment is viewed cross-sectionally using intravascular ultrasound, it gives a clear and
precise imaging that helps the surgeon in performing the procedure with utmost
accuracy.

Intra Vascular Ultra Sound (IVUS) is better than routine angiography in the
following ways.
Severity of the lesion – By measuring the area of the blood vessel in cross section
than its diameter the accuracy of the assessment increases significantly. The
angiography being a 2D imaging uses the diameter as the measuring index.
Morphology and Histology of the Lesion – IVUS and OCT provide direct information
about the nature of the blocks, whether it is made of cholesterol deposits, fibrous tissue
deposits or calcium deposits. This information is crucial in deciding the further course of

action during angioplasty. It helps to decide the need for Rotablation in severally
calcified blocks. It can also help in deciding if there are blood clots inside the blood
vessel and the presence of haemtomas.
Optimisation of stent deployment – After a stent has been placed in the coronary
artery, it is very important to know if this stent is placed correctly and if the stent is well
opposed to the blood vessel wall. This information is crucial in the long term results of
the angioplasty

In CTO Procedures – IVUS has a unique role by being able to provide complex
information on the wire position in a 360 degree perspective and also provide
information on entry points in the proximal cap. Using IVUS and OCT during CTO
angioplasty and improve the success rates and the long term results.
At the workshop Dr. Dr. IMAD SHEIBAN, Director, Interventional Cardiology, Pederzoli
Hospital, Italy, demonstrated some specialised techniques and emphasised,
“Intravascular Ultrasound (IVUS) is better – By measuring the area of the blood vessel in
cross section than its diameter the accuracy of the assessment increases significantly.
Image guided precision angioplasty is a procedure that transformed cardiac care and
helped to improve patient care.”
In the last 5 years, strong data is available to prove that adding other imaging modalities
like Intra Vascular Ultra Sound (IVUS) and Optical Coherence Tomography (OCT)
improves the outcomes of Angioplasty both short term and long term. It is undoubtedly
the best way to perform complex angioplasties.
Dr. Anand Gnanaraj, Senior Interventional Cardiologist, Apollo Speciality Hospitals,
Vanagaram, Chennai, "Major adverse cardiac events (MACE) were significantly
reduced by 64% by IVUS guidance compared to angiography alone. In cardiovascular
medicine, only a few interventions/medications have been shown to reduce clinical
outcomes so dramatically as IVUS-guided percutaneous coronary intervention.
Reducing cardiac events after a procedure to such magnitude is a very crucial
milestone in interventional cardiology.”
Apollo Speciality Hospitals at Vanagaram has been the pioneer in India launching the
first centre dedicated to the field of Chronic Total Occlusions (CTO) offering angioplasty
procedures for 100% blocked arteries. The CTO centre of Excellence has the best
technology and the latest equipment like IVUS, a technology that is used in very few
centre across the country to assist in CTO procedures. IVUS technology is the most
powerful and safe tool to perform these complex procedures. Dr. Anand Gnanaraj at the
Apollo Speciality Hospitals Vanagaram has performed more than 100 CTO
angioplasties in the last year with success rates surpassing the International success
rates. Combining the various imaging modalities increases the success rates of CTO
procedures, as it offers the best technical support to the advanced skills by the doctor .
The use of various modalities like IVUS, modern cardiac catheterization suites, CT
Coronary Angiography, Cardiac MRI and Coronary guide wires, micro-catheters,

balloons and Intra Vascular Ultra Sound (IVUS) and Optical Coherence Tomography
(OCT) contribute significantly to the overall success in the procedure and the long term
benefit for the patients.

ABOUT APOLLO HOSPITALS
It was in 1983, that Dr. Prathap Reddy made a pioneering endeavour by launching India’s first corporate
hospital – Apollo Hospitals in Chennai. Over the years Apollo Hospitals has established itself as home to
the largest cardiac practice in India with over 160,000 cardiac surgeries. Apollo Hospitals is also the
world’s largest private cancer care provider and runs the world’s leading solid organ transplant program.
As Asia’s largest and most trusted healthcare group, its presence includes 9,215 beds across 64
Hospitals, 2,500 Pharmacies, over 90 Primary Care and Diagnostic Clinics, 110 plus Telemedicine
Centres and 80 plus Apollo Munich Insurance branches spanning the length and breadth of the Country.
As an integrated healthcare service provider with Health Insurance services, Global Projects Consultancy
capability, over 15 medical education centres and a Research Foundation with a focus on global Clinical
Trials, epidemiological studies, stem cell & genetic research Apollo Hospitals has been at the forefront of
new medical breakthroughs with the most recent investment being that of commissioning the first Proton
Therapy Center across Asia, Africa and Australia in Chennai, India. Every four days, the Apollo Hospitals
Group touches a million lives, in its mission to bring healthcare of International standards within the reach
of every individual.
In a rare honour, the Government of India issued a commemorative stamp in recognition of Apollo's
contribution, the first for a healthcare organization. Apollo Hospitals Chairman, Dr. Prathap C Reddy, was
conferred with the prestigious Padma Vibhushan in 2010. For more than 30 years, the Apollo Hospitals
Group has continuously excelled and maintained leadership in medical innovation, world-class clinical
services and cutting-edge technology. Our hospitals are consistently ranked amongst the best hospitals
globally for advanced medical services and research.