Globally, coronary artery disease (CAD) is a common cause of death. Traditional coronary angioplasty bypass grafting (CABG) and percutaneous coronary intervention (PCI) are popular methods for managing CAD. PCI is a preferred intervention, while CABG is reserved for complex cases. However, some patients have associated risk factors that make them unsuitable for surgery.
Cardiologists now use the CHIP (Complex, High-Risk Indicated) angioplasty approach for patients with complex, high-risk, and severe coronary disease.
Who is eligible for CHIP angioplasty?
Once after reviewing the medical condition of the patient, the CHIP program team will decide whether the person is a potential candidate for CHIP angioplasty. However, individuals who meet the following criteria are considered as potential candidates for CHIP angioplasty:
- Advanced age- People with advanced age may not be able to tolerate bypass surgery and its complications.
- History of kidney disease, stroke, or diabetes- The presence of co-morbid conditions may complicate the surgery and its outcome.
- Location of CAD, including left main or bifurcated disease- The blood vessel is difficult to access and treat.
- Chronic total occlusion (CTO) of the coronary arteries- CTO may cause sudden heart attack, and are dangerous.
- History of open-heart surgery- Patients who have undergone open-heart surgery may be poor candidates for bypass surgery.
- Advanced stage of heart failure- The failing may not be amenable to the stress of the bypass surgery.
How is the treatment plan developed?
The CHIP team will review and discuss the patient condition. Based on the extent of CAD (despite medical therapy), co-morbidities, and hemodynamic state, the treatment plan may include:
- Surgical intervention
- Conventional PCI
- Protected PCI
- Medical management
The success of a CHIP program is dependent upon:
- Highly skilled and experienced doctors
- Advanced equipment
- An expert and well-coordinated team of doctors, paramedics, nursing and support staff
CHIP angioplasty techniques
CHIP angioplasty comprises of advanced techniques like:
- Rotational atherectomy: It is a common type of atherectomy device for plaque removal. Currently, this technique is used for ostial and heavily calcified lesions, which cannot be treated with balloon angioplasty.
- Complex bifurcation stenting: This type of stenting is used to remove the blockage from the site where the blood vessel divides into two.
- Specialized antegrade and retrograde chronic total occlusion (CTO) approaches.
What are the benefits of CHIP angioplasty?
CHIP angioplasty offers the following benefits:
- Reduces symptoms
- Improves the quality of life
- Confers lower risk of re-hospitalization