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Intracoronary physiology - To stent or not?

Intracoronary physiology plays a pivotal role in assessing the functional significance of coronary lesions. FFR and iFR provide objective, lesion-specific data that guide revascularization decisions beyond angiographic appearance. This physiological guidance ensures stenting is reserved for lesions that truly warrant intervention, improving patient outcomes.

Why IVUS or OCT

Intracoronary imaging with IVUS or OCT enhances lesion assessment, stent sizing, and optimization beyond what angiography alone can offer. These modalities provide high-resolution, intraluminal detail crucial for precise PCI planning and improved long-term outcomes.

Bioresorbable Vascular Scaffold:

BVS is a temporary, non-metallic scaffold designed to restore vessel patency and provide transient support following angioplasty. Unlike traditional stents, it gradually resorbs over time, potentially allowing the vessel to regain natural vasomotion and reducing long-term implant-related complications.

Rotablation

Rotational atherectomy is an adjunctive technique used in heavily calcified coronary lesions, facilitating optimal stent delivery and expansion. It employs a high-speed, diamond-tipped burr to selectively ablate calcified plaque, improving lesion compliance and procedural success.

Revolutionary Excimer Laser Treatment

ELCA offers a unique approach to complex coronary lesions, using ultraviolet laser energy to vaporize atheromatous and thrombotic material. Particularly useful in under-expanded stents, thrombotic lesions, and in-stent restenosis, it enhances procedural efficacy in challenging anatomies.

Orbital atherectomy

Orbital atherectomy is an advanced plaque-modifying technique designed for the treatment of severely calcified coronary lesions. By using a diamond-coated crown that orbits eccentrically, it facilitates controlled ablation and vessel compliance, enabling optimal stent deployment.

TAVI

TAVI is a minimally invasive procedure for patients with severe aortic stenosis who are high-risk for surgical valve replacement. It enables valve deployment via a catheter-based approach, offering significant hemodynamic improvement with reduced perioperative morbidity.

TMVR:

TMVR is an evolving, catheter-based therapy for patients with severe mitral valve disease who are unsuitable for conventional surgery. It enables valve replacement via a transseptal or transapical approach, offering a less invasive alternative with promising clinical outcomes.

MitraClip

MitraClip is a percutaneous device designed to reduce mitral regurgitation by approximating the mitral leaflets. It offers a minimally invasive treatment option for patients with symptomatic mitral valve insufficiency who are at high surgical risk.

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Efficiency thy name is Dr. Sengottuvelu. Really appreciate the Dr and his team . A word of appreciation to the very smart secretary Ms .Anuradha

I am extremely happy that I am being guided by an evidence based Doctor and Senior Consultant in Dr.G. Sengottuvelu for my cardiac treatment. Receptive and a dependable Doctor and I am happy. GS heart clinic has a wonderful team steered by Mrs. Anuradha , Mr. Dakshinamoorthy and the supporting Dr. You get a positive vibes as you enter

Dr.Sengottuvelu is a very gentle, caring , pleasant and takes time to listen to our concerns. I love the personal service and attention I receive when I visit him. He is highly knowledgeable and down to earth. If we are under his care and treatment we can be assured that we are in safe hands.”

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