Given the ageing population of the country, CTO angioplasty will be on the rise: Dr A V Ganesh Kumar – ETHealthworld.com

Shahid Akhter, editor, ETHealthworld spoke to Dr A V Ganesh Kumar, Sr Consultant Interventional Cardiologist & Head, Dept of Cardiology, Dr LH Hiranandani Hospital, Mumbai, to know more about the growing need for CTO angioplasty and the challenges associated with it.

Chronic Total Occlusion (CTO) Angioplasty: Trends CTO Angioplasty is the most complex subset of angioplasties where there are hard old blocks. The present trend is that with the increasing ageing population of India and lack of penetration of angioplasty to a lot of elderly patients, we are having a lot of patients of this particular subset which have been left untreated both by cardiologists and cardiac surgeons.

Among different types of angioplasties, CTO angioplasty will be on a rise and it needs to be addressed. 30% of any angiogram you do will have some or other form of CTOs that exist in more than one block per patient. Globally, the chance of a patient getting an angioplasty or bypass early on when the disease has been picked up is much better as compared to India. An untreated block, when you leave it for a long period of time gets converted into a CTO.

Chronic Total Occlusion (CTO) Angioplasty: Challenges The challenges are divided into technical challenges and financial challenges. It requires special training to address CTO angioplasties, it is much beyond just passing the wire. There are specialised wires that come from Japan. There are special wires and devices with which you tackle these hard calcified old blocks and with this, you should be able to open this block.

In doing a CTO angioplasty which involves a lot of cost to be used, cost of CTO angioplasty can be more than two to three times than the cost of routine angioplasty. So not many people would be keen to get a procedure like a CTO done purely for economic reasons or rather the reimbursements also continue to question your programme of CTO.

This is going to be the 8th programme which we are doing in June 2020 to enhance the knowledge of other cardiologists. This is done for the training of CTO in India.

Chronic Total Occlusion (CTO) Angioplasty at Dr LH Hiranandani CTOs in any hospital don't amount for more than 5 per cent of the work among the total angioplasties that we do in our hospital, we end up doing 30 per cent of the cases as we get a lot of patients.

Chronic Total Occlusion (CTO) Angioplasty: Future More and more cardiologists are picking up, and they are doing it in even smaller tier 2 cities which is a plus but the minus continues to be an economic burden both on the patient as well as the reimbursement. They need to understand that by cutting cost in CTO you cannot perform a CTO.

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Given the ageing population of the country, CTO angioplasty will be on the rise: Dr A V Ganesh Kumar - ETHealthworld.com