It’s been over 35 years since the first angioplasty was performed in Zurich by Dr. Andreas Gruentzig, but it was just yesterday that this minimally invasive procedure arrived in Australia’s Northern Territory.
As reported today by Sky News, Dr. Marcus Ilton, chief cardiologist at Royal Darwin Hospital, performed the first angioplasty and stent implantation ever done in the NT.
The patient was a 65-year-old man with a 90% blocked coronary artery. According to Dr. Robert Parker, vice-president of the NT’s Australian Medical Association, the reason that it has taken so long is that, until just five years ago, the Australian Cardiac Society guidelines wouldn’t allow angioplasties to be performed in hospitals like Darwin, which is in a very remote area, does not have a cardio-thoracic surgical team on site, and could not ensure that patients who suffered complications could be transported the significant distance to a larger hospital in a timely fashion.
Dr. Ilton explained that it now is possible to perform angioplasty without full surgical backup on site, due to improved technology.
In fact, the massive reduction in the number of angioplasty patients worldwide who require emergency bypass surgery due to complications has dropped considerably in the past 20 years primarily due to the invention of the stent. In the era of “Plain Old Balloon Angioplasty” or POBA, 2-5% of angioplasties resulted in the wall of the artery collapsing after the balloon was inflated and deflated. If a repeated inflation did not repair the damage, the patient needed to be rushed to a surgical suite in the hospital for emergency bypass surgery. The introduction of stents, or scaffolds, virtually eliminated this problem. The great majority of angioplasty procedures now include a stent placement.
The Northern Territory comprises 10% of Australia’s land mass. It’s almost twice the size of Texas but with a population of only 233,000, that of a small U.S. city such as Baton Rouge or Winston-Salem or Reno. (It should be noted that Australia has been the home of many advancements in interventional cardiology: for example, Dr. Ian Meredith of Monash Heart in Melbourne and others have been among the first in the world to research innovative treatments such as bioresorbable stents, new drug-eluting stent designs, transcatheter valve replacements, etc.)
According to the Sky News report, the Northern Territory government has earmarked $6.5 million for this effort and over the next six months a team from Adelaide in the South will be training Royal Darwin Hospital staff in the procedure. Dr. Ilton is quoted: “This is the beginning of a new era: bringing high-end, top technology services to the territory and providing a service that people expect everywhere in Australia, but, until yesterday, had not been available here.”
Congratulations to the staff at Royal Darwin Hospital!