Today's fast-changing lifestyle has resulted in a growing number of Thais becoming victims of heart disease. According to a study conducted by the Chest Surgery Association in 2003, the number of patients with cardiac problems increased by 14.1 per cent over a three-year period.

Around 81 per cent of these patients are diagnosed with coronary artery disease and need to undergo a coronary bypass graft, also known as a balloon angioplasty.

According to Dr Damras Tresukosol, interventional cardiologist and Associate Professor of Medicine at Siriraj Hospital, advanced technology has already taken balloon angioplasty to another level.

Through the advent of state-of-the-art detection and evaluation technology called Intravascular Ultrasound (Ivus), balloon angioplasty can now be carried out with optimal results.

Balloon angioplasty is usually the preferred option for the treatment of coronary artery disease, as it does not require the patient to undergo an operation, allows faster recovery and reduces the risk of infection.

However, if not performed effectively, the patient faces the risk of restenosis - the re-narrowing of the artery after balloon angioplasty.

Before a balloon angioplasty is performed, surgeons have to conduct contrast angiography, which has long been the most popular technique in detecting and evaluating coronary heart disease. This process enables the doctor to see a one-dimensional view of the clogged artery.

This technique, however, has some limitations as the one-dimensional images cannot show the condition of the blood vessel wall, identify the plaque and fat build-up in remodelled vessels, or detect vessel-wall disruption during the angioplasty.

As a result, there are times when the stent - the plastic tube inserted during angioplasty - is not properly fitted into the artery wall, thereby increasing the risk of restenosis of the artery due to the body's natural tendency to heal itself.

Ivus was developed to overcome these limitations. Using ultrasound technology, Ivus can provide real-time, high-resolution pictures from inside the blood vessels.

With a specially designed long thin catheter, Ivus uses ultrasound technology to see inside the arteries and visualise the inner wall of blood vessels.

In a departure from traditional methods of detection and diagnosis, the cardiologist steers a coronary guidewire into the blood vessel.

The ultrasound catheter tip is then slid over the guidewire, transmitting sound waves to the external computerised ultrasound equipment, which displays real-time ultrasound images of the section of the blood vessel surrounding the catheter tip.

In this way, the operator can accurately determine the degree of the narrowing in the arteries and can even detect cholesterol, calcium,  and plaque progression that is not usually visible through an angiogram.

This can be done while the patient is conscious and involves minimal pain.

Records show that with the use of Ivus, the results of balloon angioplasty are more effective and successful than before.

Prof Damras recently performed a live broadcast demonstration of balloon angioplasty using Ivus to Asian heart specialists attending the  third Malaysian Cardiovascular International Symposium in Malaysia.

With Ivus is still a relatively new technique though, it is only available at leading medical centres like Siriraj Hospital's Heart Unit.