Gauteng-based cardiologist, Dr Chris Zambakides, acted as a proctor to oversee and assist local cardiovascular specialists to successfully perform two of these new highly intricate procedures at the catheterisation laboratory at the cardiovascular centre at Netcare St Anne’s Hospital.
According to Dr Kyle Shein, a cardiologist at hospital, the two procedures included a rotational endarterectomy (rotablation), in which a tiny drill powered by compressed air and special fluid to clear the calcified deposits were used, and a percutaneous coronary intervention to chronic total occlusion (CTO) to re-canalise a chronically blocked portion of an artery.
“This training session, which proved most valuable to our local specialists, was made possible through a sponsorship by Boston Scientific. We are also most grateful to Dr Zambakides for making his time available to impart his knowledge and rare set of skills to local doctors.”
Dr Zambakides, who was trained extensively in complex catheterisation procedures abroad, explains that rotablation involves advancing an extremely small drill head to the site of the blockage in the blood vessel, using catheter wires through a puncture in the skin.
The calcified blockage in the blood vessel is drilled away and thereafter a balloon or stent is forwarded to the diseased site and inflated to ensure that the vessel remains open.
In the case involving the chronic totally occluded vessel, special micro-catheters, which have been developed in Japan, were used to successfully treat and re-canalise a lesion through tiny micro-channels. One micro-catheter was advanced forward into the artery while another was advanced through the opposite artery of the chronically occluded artery.
“There are still only a few cardiovascular specialists in South Africa and overseas who are familiar with treating chronic total occlusion. These are highly intricate procedures to perform and do take some training,” says Dr Zambakides.
“Programmes such as this are to be commended as they are seeking to impart the necessary skills to more specialists throughout our country. As proctors we are able to demonstrate the procedures and carefully guide interventional cardiovascular specialists through the operations so that they are able to get practical hands-on experience.”
“Ever more sophisticated technology is constantly being introduced and there is an ongoing improvement in techniques. It is important that we in South Africa are able to stay abreast of these developments.”
