Tag: Apollo Health City

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Apollo Hospitals reports first successful use of Intravascular Lithotripsy in India in treatment of severely calcified carotid artery stenosis

Apr 29, 2021 by Rekha Nair 0 Comments #Apollo Health City, #Apollo Hospitals Group, #Cath Lab & Interventional Cardiology, #Dr Sangita Reddy, #Dr. P C Rath, #Hyderabad, #Intravascular Lithotripsy, #Joint Managing Director, #Sr. Consultant Cardiologist & Director

Hyderabad: Apollo Hospitals today announced the first successful use of Intravascular Lithotripsy in India to treat a 75-year-old male patient with heavily calcified carotid artery lesions.The patient, who presented with recurrent CVA (cerebrovascular accident) or strokes, was successfully treated by transcarotid arterial revascularisation (TCAR) using Intravascular Lithotripsy (IVL). With only a few cases reported from USA and Italy using IVL to treat carotid artery stenosis or narrowing, the achievement by the team of doctors at Apollo Health City, Hyderabad of the first reported use of this technique in India is a milestone in carotid angioplasty and stenting procedures in the country.

Dr. Sangita Reddy, Joint Managing Director, Apollo Hospitals Group said, “At Apollo Hospitals, we are always looking to set new standards of care with advanced medical technology that lets our doctors undertake challenging procedures safely and successfully. The first reported use of IVL in India to treat calcified carotid artery lesions will enable us to treat patients who cannot go in for conventional procedures. It will decrease the risk of procedural complications, providing positive clinical outcomes with reduced risk of future adverse events. It is a testament to the dedication and skill of our doctors that they have continued to focus on treating and saving lives of patients with NCDs even during the pandemic.”

Dr. P C Rath, Sr. Consultant Cardiologist & Director, Cath Lab & Interventional Cardiology, Apollo Health City, Hyderabad said, “The patient presented with recurrent strokes. Upon evaluation, he was found to have a critical stenosis involving the right internal carotid artery. There was also significant calcification of the vessel and a 180o arc of deep wall calcium. This required urgent intervention to open up the vessel since carotid artery stenosis (CAS) is responsible for around 30% of ischemic strokes.The conventional treatment option of carotid endarterectomy, that is, surgical approach to remove plaque from the artery was not recommended due to advanced age and comorbidities that included hypertension and a prior CABG (coronary artery bypass graft surgery). A direct stent implant through the minimally invasive transfemoral carotid artery stenting was also not advisable due to the severely calcified plaque that would prevent proper stent expansion with sub-optimal dilatation of the artery. It was decided to proceed with Intravascular Lithotripsy that combines the combines the calcium-disrupting potential of lithotripsy with the expertise that we hold in use of balloon catheters.”

Intravascular Lithotripsy (IVL)works through generating sonic waves, which are sonic pressure waves. This is a novel use of the concept of lithotripsy, that has been safely used for decades to treat kidney stones by safely breaking up the stones. The sonic waves in IVL pass through the soft tissues of the arterial wall lining, and the pulsatile energy safely disruptsthe calcium in the plaques, creating micro-fractures in the calcium. The broken-up calcium allows expansion of the artery at low pressure thus permitting the safe implantation of a stent with minimal trauma to normal arterial tissue and improving the blood flow. The procedure is safer as the calcium fragments resulting from the IVL therapy remain in situ, with a reduced likelihood of breaking off and embolising.

Dr. P C Rath added, “A new tool called Shockwave intravascular lithotripsy that has been recently approved for the treatment of heavily calcified lesions in coronary and lower limb arteries was used to treat the heavy calcification in the carotid artery. While minimal data exists for its use in treating calcified plaques in carotid artery, we decided to proceed with IVL as the patient’s age and co-morbidites would not permit conventional treatment methods. However, the underlying calcium is known to result in suboptimal outcomes following stenting through percutaneous intervention. Aggressive post-dilatation in the carotid region often results in severe bradycardia (slowing down of heart rate) and hypotension (low blood pressure). IVLfacilitated adequate stent expansion and we were able to successfully perform the dilatation with minimal residual stenosis.

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Apollo Hospitals performs South India’s first Daycare minimally Invasive Total Hip Replacement!

Mar 11, 2021 by Neel Achary 0 Comments #Apollo Health City, #Consultant Orthopedic Surgeon, #Dr Paripati Sharat Kumar, #Orthopedic surgeons at Apollo Hospitals

Hyderabad: The team of Orthopedic surgeons at Apollo Hospitals led by Dr Paripati Sharat Kumar, Consultant Orthopedic Surgeon, Apollo Health City; performed south India’s first minimally invasive Daycare Total Hip Replacement Surgery on a 22-year-old international patient Mr Liban, a student from Somalia, Africa; at Apollo Health City, Hyderabad. The patient was able to sit, stand and walk within 6 hours and was discharged in 7 hours post-surgery.

The trauma he was enduring began a couple of years ago and gradually aggravated inspite of taking medicines and physiotherapy. The condition was impacting his daily routine, walking and climbing stairs was an excruciatingly painful experience. As it didn’t seem to subside and started crippling his mobility further, he approached Dr Sharat Kumar complaining of severe pain in left hip. Investigations including ‘X’ Ray, revealed severe arthritis in his hip due to Ankylosing Spondylitis, warranting left total hip replacement.

Ankylosing Spondylitis is an inflammatory condition affecting spine and hip joints. No specific cause is known for it, but the presence of a genetic factor called Human Leucocyte Antigen [HLA-b27] increases the incidence of the disease, which is 0.4 to 14 per 100,000 persons-year. Ankylosing Spondylitis leads to gradual loss of articular tissue and is replaced with bone, resulting in fusion causing stiffness and immobility, leading to bamboo spine and hip joint fusion.

Mr Liban, being young and healthy except for Ankylosing Spondylitis, was considered an ideal patient for day care direct anterior total hip replacement. A minimally invasive uncemented total hip replacement surgery using jumbo cup with 36mm ceramic head implants, was done through a minute incision of about 4 to 5 inches. He has since recovered and is undergoing physiotherapy.

The minimally invasive Daycare Total Hip Replacement surgery has multiple advantages over the conventional open surgery, including relatively smaller incision, minimal bleeding, quicker recovery and also lesser chance of complications, particularly dislocation and infection. However, a robust multidisciplinary support system is vital for it to be effective. Also, the patient selection is critical, as all patients are not suitable for it and every case has to be considered on an individual basis in order to avoid complications later, particularly in the elderly and those with multiple medical conditions.

The minimally invasive Daycare Total Hip Replacement surgery is the latest and will be the preferred choice for most hip replacements in the years to come. In fact, reports predict that 50% of all joint replacement will be performed through Daycare by 2027, considering the enormous benefits they bring along, like being back home same day, faster recovery, less infection, economic advantage, minimal disturbance to regular routine to the patient and family etc., says Dr Sharat Kumar. The precision in joint replacement technique and advances in technology brought in many changes in implant designs, giving joint more stability as well as longevity, he adds.

Mr Liban has been advised to be in India for a fortnight, as the perioperative period is crucial and no compromise in care is prudent during this phase of the treatment. His stay will be utilized to remove sutures and for him to acclimatized to physiotherapy routine, which is an integral and important part of the treatment to restore strength and flexibility.

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Day care, Fasttrack Total Knee Replacement, performed at Apollo Health City, set to revolutionise knee care!

Nov 17, 2020 by Gouri Achary 0 Comments #Apollo Health City, #Dr K J Reddy, #Fasttrack Total Knee Replacement, #Mrs Rita Verma

Apollo Health City, Hyderabad, performed the first ‘Fast track Total Knee Replacement’, in south India. Fast track Total Knee Replacement is a daycare knee replacement surgery, devoid of hospital stay, minimal aftereffects of anaesthesia, pain, trauma, infection, above all speedy recovery and being back to normal routine in a couple of days.

The revolutionary surgery was performed on a known diabetic 65-year-old female patient, by a team led by Dr K J Reddy, Senior Consultant Orthopaedic Surgeon, Apollo Hospitals, Hyderabad, on November 2nd, 2020. The patient was discharged the same evening after eight hours of post-surgery observation, she has fully recovered since and is going about with her routine with ease and great comfort.

Total knee replacement (TKR) is a commonly performed but advanced orthopaedic procedure for severe, disabling knee pain due to Knee Arthritis. The excruciating knee pain often limits patient mobility and daily routine, warranting Total Knee Replacement. The surgery involves the replacement of surfaces of the damaged knee joint with a high-quality metal implant, which restores the patient ability to walk pain-free as before. Being a major procedure, it needs 3 to 4 days of hospital stay traditionally.

The latest advances in perioperative management revolutionise Total Knee Replacement, reduces hospital stay to less than a day, enables the patient to be on his legs quickly and embrace an independent, superior quality life, says Dr K J Reddy.

The patient who underwent first Fast track Total Knee Replacement, Mrs Rita Verma, was unable to walk properly and perform her routine, due to severe pain in left knee because of degenerative osteoarthritis. The minimal trauma and being able to return home the same day appealed to her and family and they opted for the Fastrack procedure. Being a known Diabetic, she underwent thorough pre-anaesthetic evaluation and after being deemed to be fit for surgery, was admitted early in the morning of November 2nd.

Post an uncomplicated and successful surgery, she was kept under observation for eight hours and was discharged by 2 pm the same day. Later at home, she was constantly monitored for the next two days by a nurse with the aid of all vital monitoring equipment and monitors, installed by Apollo Home Care Team at her home. A Physician and Physiotherapist visited her on both the days while the E-ICU facility at Apollo Hospitals ensured round the clock observation by Senior Doctors and critical care team from the hospital. The round-the-clock and high-quality care coupled with physiotherapy enabled her to walk pain-free the very next day.

The Fast Track surgery with enormous patient benefits is set to revolutionise knee replacements in India, in no time the traditional knee surgery may become redundant. Treating surgeons and support teams being adept with latest techniques, aided by state-of-the-art E-ICU facilities, can bring about a rapid transition, says Dr K J Reddy.

The Fast track Total Knee Replacement is a sophisticated procedure currently performed only at few centres having the requisite infrastructure and proficient specialist teams. It involves using advanced surgical techniques performed with miniature instruments while administering regional anaesthesia limited to the leg region. Miniature instruments ensure minimal incision, that coupled with regional anaesthesia significantly diminishes pain, trauma, complications, infections and side effects generally associated with surgery, besides aiding in the patient recouping fast.

The post-surgery recovery period spent at home with suitable and manageable precautions substantially reduces the scope of infection. The homely ambience, home-cooked food and staying amidst dear ones, accelerates recovery by manifold. However, the treating surgeon needs to be extra cautious while selecting the patient for this procedure, as patients over 80 years of age and those with co-morbidities need to be thoroughly assessed and only those found to be suitable should be considered for the new procedure.