Angioplasty Stenting (PCI) in India
In this article, we have covered the following:
- Understanding Angioplasty
- Best Hospitals for Coronary Angioplasty in India
- Top Interventional Cardiologists in India
- Cost of Coronary Angioplasty in India
- How to Proceed- How we Help!
Best Doctors and Hospitals for Coronary Angioplasty in India
Following is a list of the most reputed specialists in India for Angioplasty Stenting.
Please click the ‘contact doctor‘ button on the right side for seeking opinion or requesting an appointment with your chosen specialist.
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Cost of angioplasty in India
The cost of angioplasty in India is about USD 4,000 & about 500 extra for each drug-eluting stent (the most popular variety)
Angioplasty is a non-surgical procedure to clear blockages in the heart arteries. It clears or unblocks the narrowed or blocked arteries that are the reasons for chest pain or heart attacks. It is done in the cardiac catheterization laboratory or cath-lab by Interventional Cardiologists who insert a catheter through a wire into the narrowed blood vessels. The balloon is then inflated to a fixed size to expand the vessel and then deflated and withdrawn. The procedure takes about one to three hours to complete.
Angioplasty is one of the most common heart procedures done today. It is estimated that about one-third of patients with Coronary Artery Disease (CAD) undergo coronary angioplasty stenting. Every year 300,000+ angioplasties are done in India.
Clinical indications for PCI are as follows:
- Acute ST-elevation myocardial infarction (STEMI)
- Non-ST-elevation acute coronary syndrome
- Stable angina
- Angina equivalent (eg, dyspnea, arrhythmia, dizziness/syncope)
- Asymptomatic or mildly symptomatic patients with evidence of a viable myocardium or symptoms of ischemia on noninvasive investigations.
Clinical contraindications include significant comorbidities (a relative contraindication)
Indications for PCI include hemodynamically significant significant lesions or blockage in vessels supplying viable myocardium (good sized coronary vessels; diameter >1.5 mm).
Angiographic relative contraindications are as follows:
- Left main stenosis- coronary artery bypass grafting [CABG] is the preferred treatment for left main stenosis; however there are certain cases of PCI in left main stenosis cases also
- Diffusely diseased small-sized artery or CABG vein graft
- Other coronary anatomy not amenable to PCI
Other Contraindications to a coronary stenting are as follows:
- Patients in whom antiplatelet and/or anticoagulant therapy is contraindicated
- Blockage or stenotic Lesion that prevents complete opening of an angioplasty balloon or proper placement of stent
Coronary stents are implemented after balloon angioplasty. The delivery system consists of a balloon-tipped catheter, over which the collapsed desired sized stent is threaded. Once the stent is advanced at the stenotic site, the balloon is inflated to expand the stent using ballon of delivery system. The stent subsequently becomes endothelialized over the period of time.
Stents are of 3 types:
- Bare metal stents( stainless steel, cobalt chromium alloy, or nickel chromium alloy)
- Drug eluting stents– stents with a polymer coating or antiproliferative drug, which release drugs into the coronary wall for weeks to months after coronary stenting procedure
- Bioabsorbable drug eluting stents which are made up of special bioabsorbable polymer
Bare metal stents are rarely used now because of recent advancement and lot of research in the coronary interventions. Drug eluting stents have less chances of stent thrombosis due to elution of drug for weeks to month.
Bare metal stent differ from each other with respect to element (eg, stainless steel, cobalt chromium alloy, or nickel chromium alloy), design, and delivery system used ( balloon catheter that delivers the stent, self-expanding, or balloon expandable).
Drug Eluting Stents are balloon-mounted, expandable, slotted tubular / multilink scaffolds made of a stainless steel or cobalt chromium . Stent has a polymer with antiproliferative drug, which allows drug elution for weeks to months to reduce the local proliferative healing response.
Angioplasty or Bypass surgery?
Both angioplasty and bypass surgery (CABG) are basically the procedures to clear the blocked arteries for allowing smooth blood flow. Based on type of blockage and other medical conditions, your cardiologist decides, which procedure to perform of the two. Generally angioplasty is done in case of one to three arteries blockage while bypass is considered when there is significant blockage of main coronary arteries or when all the three coronary arteries are blocked.
Recovery after angioplasty
The recovery of angioplasty patients is faster. The hospital stay is about one day. You would be able to walk within two to six hours and return to normal activities in a week. But you need to avoid physical activities, strenuous work or any kind of weight lifting for about two weeks. A gradual exercise regime would be recommended by your doctors.
In case of stents, medications for up to one month to one year would be prescribed, based on your medical condition, to prevent blood clots.
For complete recovery and preventing recurrence of the disease, it is essential to maintain a healthy lifestyle minus smoking, high cholesterol diet and weight gain.
Note (for foreign patients):
Besides South Asian countries (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan, Sri Lanka), every year, India gets thousands of medical tourists from African countries- Nigeria, Kenya, Ethiopia, Sudan, Uganda, Ghana, Somalia,Gambia etc and Middle Eastern countries like Iraq, Iran, Saudi Arabia, Oman, UAE, Yemen etc. Hence, if you are a citizen of any of these countries, there is good likelihood that you will be meeting some fellow citizens or same language speakers in the major hospitals in India. Almost all the top hospitals have translators for people of these region. Our patient support team is also well placed to assist you.