Heart disease remains the leading cause of death worldwide, with coronary artery disease (CAD) being a major contributor. Over the past two decades, there have been groundbreaking advancements in cardiology—from traditional angioplasty to modern stenting techniques. But the game truly changes when two powerful innovations converge: Drug-Coated Stents and Intravascular Imaging (IVI).
At Fortis Institute of Cardiovascular Sciences, Noida, under the leadership of Dr. Sanjeev Gera, we are proud to be at the forefront of this transformative approach, offering patients more precise, safer, and longer-lasting cardiovascular care.
Drug-coated stents, often called Drug-Eluting Stents (DES), are tiny mesh tubes inserted into narrowed or blocked coronary arteries. Unlike bare-metal stents, DES are coated with medication that is slowly released to prevent restenosis (re-narrowing of the artery).
Reduced risk of restenosis compared to bare-metal stents
Lower rate of repeat interventions
Improved long-term outcomes in complex cases like diabetes, long lesions, or small vessels
However, even the best stent will fail without optimal placement. That’s where intravascular imaging comes into play.
Intravascular imaging refers to advanced imaging techniques used inside the arteries to guide and optimize stent implantation. The two most commonly used modalities are:
Intravascular Ultrasound (IVUS)
Optical Coherence Tomography (OCT)
These tools provide real-time, high-resolution cross-sectional images from inside the blood vessel, allowing cardiologists to see the plaque burden, artery size, dissections, and stent apposition with incredible detail.
A stent that is under-expanded, malapposed, or deployed over residual plaque can lead to complications such as:
In-stent thrombosis
Restenosis
Myocardial infarction
Imagine having both a therapeutic and a diagnostic powerhouse working in tandem. That’s what this combination delivers. Let’s break it down:
| Issue | Without IVI | With IVI |
|---|---|---|
| Plaque not fully cleared | Often missed | Clearly visualized |
| Stent under-expansion | Common cause of failure | Immediately corrected |
| Edge dissection | May go undetected | Detected and managed |
| Sizing of artery | Estimated visually | Measured precisely |
This strategic pairing is especially beneficial in complex PCI cases, bifurcation lesions, left main disease, and in patients with diabetes or chronic kidney disease.
A 63-year-old diabetic male presented at Fortis Hospital, Sector 62, Noida with chest discomfort. Angiography revealed a tight proximal LAD stenosis. Using IVUS, we noted a high plaque burden and significant calcification. A drug-eluting stent was deployed, followed by post-dilation guided by IVUS to achieve full expansion. The patient had an excellent recovery with no complications.
Such precision is hard to achieve with angiography alone.
Helps in selecting optimal stent length and diameter
Enables detection of subtle dissections or malappositions
Reduces in-stent restenosis and thrombosis
Better long-term vessel patency
Imaging provides insights into plaque morphology, guiding plaque modification techniques like rotablation or laser angioplasty
Studies show that IVI-guided PCI leads to:
34% reduction in MACE (Major Adverse Cardiac Events)
Significant reduction in target lesion failure
According to international guidelines and Dr. Sanjeev Gera’s clinical experience, IVI is recommended in:
Complex lesions (bifurcations, left main)
Stent failure or restenosis
Long or heavily calcified lesions
Ambiguous angiographic findings
Chronic total occlusions (CTOs)
Yes. At Fortis Noida, we ensure IVI is done in a safe, radiation-conscious, and cost-effective manner. While it may marginally increase the upfront cost, the long-term savings from reduced repeat procedures and complications make it a wise investment in health.
With over 20 years of experience, Dr. Gera is a pioneer in promoting evidence-based cardiology. His patient-first approach, deep expertise in intravascular techniques, and global collaborations make Fortis Noida a trusted destination for advanced heart care.
Patients benefit not only from cutting-edge technology but also from Dr. Gera’s empathetic, patient-centric care philosophy.
“I had been told I needed a stent, but Dr. Gera recommended using intravascular imaging. He explained everything clearly. The procedure went smoothly and I felt reassured knowing it was done with such precision. Today, I’m back to walking 3km daily!”
— Mr. Rajeev T., Noida
Absolutely. Regular angiography offers only a 2D view, while IVI offers detailed 3D insight into the artery’s interior. When combined with drug-eluting stents, outcomes are significantly improved.
The use of IVI may add 10–15 minutes, but this time ensures better stent placement and fewer long-term issues.
Yes. Dr. Sanjeev Gera and his team are equipped with both IVUS and OCT platforms, enabling world-class care right here in Noida.
There is a marginal increase in cost due to the imaging catheter, but it saves on long-term complications, hospital stays, and repeat angioplasties.
Risks are minimal. IVI is generally safe and well-tolerated. At Fortis Noida, all precautions are taken to ensure patient safety.
The convergence of Drug-Coated Stents and Intravascular Imaging is not just a technological evolution—it’s a paradigm shift in how we treat coronary artery disease. At Fortis Institute of Cardiovascular Sciences in Noida, Dr. Sanjeev Gera is proud to lead this change, delivering state-of-the-art, evidence-based, and highly personalized cardiac care.
Dr. Sanjeev Gera
MD, DNB-Cardiology, FSCAI
📍 Fortis Institute of Cardiovascular Sciences, Rasoolpur Nawada, Sector 62, Noida
🕒 Monday to Saturday | 8:00 AM – 5:00 PM
Location: Fortis Institute of Cardiovascular Sciences, Sector 62, Noida
Author: Dr. Sanjeev Gera, MBBS, MD (Medicine), DNB (Cardiology), FSCAI
+(91)9810466173
info@drsanjeevgeracardiologist.com