5 September, 2024

Metal-Free PCI: A Breakthrough in Heart Treatment

In the realm of cardiology, continuous innovations are redefining the way we treat coronary artery disease (CAD). One such revolutionary development is Metal-Free Percutaneous Coronary Intervention (PCI), which uses bioabsorbable stents. These stents dissolve over time, offering a safer alternative to traditional metal stents.

For patients seeking expert advice on metal-free PCI, Dr. Dhamodaran K, a cardiologist with over 16 years of experience, is a leading specialist in this field. Based at Apollo Hospitals, Greams Road, Chennai, Dr. Dhamodaran K holds prestigious qualifications, including MBBS, DM (Cardio), FNB, FESC, FSCAI. He treats a wide range of cardiology conditions, from Barth Syndrome and Dilated Cardiomyopathy to Irregular Heartbeat, Orthostatic Hypotension, and Patent Foramen Ovale.

What is Metal-Free PCI?

Traditional PCI involves the insertion of metal stents to widen narrowed or blocked arteries, helping restore blood flow to the heart. While effective, metal stents come with long-term risks, such as stent thrombosis, chronic inflammation, and the necessity for prolonged use of blood thinners. Metal-free PCI, however, uses bioabsorbable stents, also known as biodegradable scaffolds, which are absorbed by the body over time, leaving no permanent foreign material in the arteries.

These stents are typically made from materials such as polylactic acid (PLA), a biocompatible substance that gradually dissolves into the bloodstream. The goal of these bioabsorbable stents is to provide support to the artery while it heals and then gradually dissolve, leaving behind a naturally functioning vessel.

Why Choose Metal-Free PCI?

Metal-free PCI has several key advantages over traditional stent placement, making it an attractive option for many patients:

1. Reduced Risk of Long-term Complications: Since bioabsorbable stents dissolve over time, there’s a lower chance of long-term complications like thrombosis or chronic inflammation, which can be associated with permanent metal stents.
2. Avoidance of Long-term Medication: Patients with metal stents often require prolonged use of blood thinners to prevent clotting. Metal-free PCI reduces the need for long-term medication.
3. Restoration of Natural Vessel Function: Over time, bioabsorbable stents leave behind a naturally functioning artery, without any foreign material remaining inside the body.
4. Lower Risk of Future Surgeries: Metal stents can sometimes complicate future procedures like coronary bypass surgery. The absence of metal in the arteries with metal-free PCI allows for greater flexibility in future treatments.
5. Advancements in Design: Recent designs of bioabsorbable stents have shown improved performance in terms of both effectiveness and safety, making this option more accessible for a larger patient population.

How Does Metal-Free PCI Work?

The procedure for metal-free PCI is quite similar to traditional PCI. Here’s a step-by-step overview:

1. Catheter Insertion: A catheter is inserted through a blood vessel in the groin or wrist and guided to the heart’s arteries.
2. Imaging and Evaluation: With the help of advanced imaging techniques like angiography, the cardiologist evaluates the narrowed or blocked artery.
3. Stent Placement: A bioabsorbable stent mounted on a balloon-tipped catheter is guided to the affected area. The balloon is inflated to expand the stent, allowing it to widen the artery and restore blood flow.
4. Absorption Process: Over the next few months or years, the stent will gradually dissolve, leaving no permanent material behind. The artery is left in a more natural state, capable of moving and flexing as needed.

Who is a Candidate for Metal-Free PCI?

While metal-free PCI is promising, not every patient with coronary artery disease is a candidate for the procedure. It is typically recommended for patients who have:

• Low-to-moderate risk for coronary artery disease.
• Small blockages or lesions in their arteries.
• A preference for avoiding long-term use of blood thinners or potential complications of metal stents.

Patients with highly complex or large blockages might still require traditional metal stents or other forms of treatment.

FAQs About Metal-Free PCI

1. How long do bioabsorbable stents last?

Bioabsorbable stents generally dissolve within 6 months to 2 years, depending on the material used and the individual patient’s healing process. During this time, the stent supports the artery while it heals.

2. Are bioabsorbable stents as effective as metal stents?

Yes, bioabsorbable stents are effective in the right patient population. However, long-term studies are still ongoing to evaluate their full effectiveness in comparison to metal stents, particularly for complex cases.

3. Do I still need to take medication after receiving a bioabsorbable stent?

While the need for long-term blood thinners is reduced, patients will still require medication immediately after the procedure to prevent clotting. The exact duration of medication depends on the individual’s condition and their cardiologist’s recommendation.

4. Can bioabsorbable stents be used in all types of blockages?

No, bioabsorbable stents are not suitable for all types of blockages. They are typically recommended for smaller blockages and may not be appropriate for patients with high-risk, complex lesions. Your cardiologist will determine whether this option is right for you.

5. Are there risks associated with bioabsorbable stents?

As with any medical procedure, there are risks involved. In the case of bioabsorbable stents, the primary risks include artery re-narrowing (restenosis) and early stent thrombosis. However, advancements in stent design and improved patient selection criteria have significantly reduced these risks.

6. How much does a metal-free PCI procedure cost?

The cost of metal-free PCI can vary depending on the hospital, geographic location, and whether additional procedures or testing are required. It is typically more expensive than traditional PCI due to the newer technology involved.

7. How soon can I return to normal activities after metal-free PCI?

Most patients can return to light activities within a few days of the procedure. However, your doctor will give you personalized instructions based on your overall health and recovery.

8. Are bioabsorbable stents approved by medical regulatory bodies?

Yes, bioabsorbable stents are approved by medical regulatory bodies in several countries, including the U.S. FDA and European regulatory authorities. However, their use might still be limited to certain patient groups.

9. Is metal-free PCI widely available?

Metal-free PCI is available in specialized hospitals and heart centers around the world. However, it may not be offered in all healthcare settings due to the need for advanced technology and expertise in the procedure.

10. What is the recovery process like after metal-free PCI?

The recovery process after metal-free PCI is similar to that of traditional stent procedures. Most patients will spend a day or two in the hospital and will need to follow up with their cardiologist regularly. Regular check-ups and lifestyle modifications are essential to ensure long-term success.

Book a Consultation

Whether you need to consult for routine heart check-ups or require specialized treatment, Dr. Dhamodaran K offers both digital consultations and in-person visits at Apollo Hospitals Greams Road in Chennai.

For appointments, you can:

• Book a Digital Consultation: Receive expert care from the comfort of your home.
• Schedule a Hospital Visit: Visit Dr. Dhamodaran K in person for a thorough evaluation and personalized treatment plan.

Contact Details:

• Hospital: Apollo Hospitals, Greams Road, Chennai
• Phone: +91-44-2829 0200