Dr. John Lopez of Loyola University Health System is using a new angioplasty technique to reopen these tough blockages by going through the “back door.”
The technique, called retrograde recanalization, was developed in Japan and is beginning to catch on in centers with advanced expertise in cardiac catheterization. It is a complex procedure that requires new catheters and tools that can pass through arteries less than 1 millimeter wide.
Lopez recently used the technique on Heliodoro Galvan, 55, of Oak Forest, Ill. Before the procedure, Galvan’s right coronary artery was completely blocked, causing fatigue and difficulty breathing.
In a conventional angioplasty, an interventional cardiologist inserts a catheter through an artery in the groin and guides it to the front end of the blockage. The catheter is passed through the blockage and a balloon on the tip of the catheter is inflated to open the artery. The cardiologist typically deploys a stent, or a wire mesh tube, to keep the artery open.
But in Galvan’s case, the front of the blockage was clogged with bone-hard deposits. So Lopez took a different route. He approached the blockage from the back end, which was softer and easier to break through with a catheter.
To reach this back end, Lopez took an alternative route that passed through narrow “collateral” arteries that are 0.5 millimeter to 1 millimeter wide. (These collateral arteries sprouted up after the right coronary artery closed up.)
Before undergoing the procedure, Galvan experienced unusual fatigue. He nearly fainted a few times at his physically demanding job. Spending a day with his grandchildren left him exhausted. And he couldn’t run more than half the length of a football field without becoming winded.
Galvan underwent the procedure Aug. 24 and went home the next day. Today, he has much more energy and can run easily for 5 or 10 minutes without stopping. He walks and jogs three or four miles every other day. He also has improved his diet and lost about 20 pounds.
“I feel a lot better,” he said. “Finally, I can go for a run.”
Lopez is director of interventional cardiology research and a professor in the cardiology division of the Department of Medicine of Loyola University Chicago Stritch School of Medicine.
Based in the western suburbs of Chicago, Loyola University Health System is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and 28 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus, Loyola University Hospital, is a 569-licensed-bed facility. It houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children’s Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola’s Gottlieb Memorial Hospital campus in Melrose Park includes the 264-bed community hospital, the Gottlieb Center for Fitness and the Marjorie G. Weinberg Cancer Care Center.