What is the first thing that comes to your mind when you hear of the power of technological innovation in healthcare? You probably picture artificial intelligence, with machine learning and robotic arms guiding surgeries. But transformation is also advancing on another, lesser-known and perhaps so far underrated, frontier - nanotechnology.
Think about it. Nanotechnology or technology on a lean scale, is especially suited to medicine because nature operates at not even a micro, but a nano scale - synapses, the extracellular spaces between neurons that exchange massive amounts of information per second are approximately only 20-40 nanometres (nm) wide.
The typical largest coronary artery, which supplies oxygen-rich blood to the heart, barely measures an inch in diameter.
Nanotechnology works with this natural nanoscale to deliver better healthcare results with fewer risks and side effects in a shorter span of time. It uses finer instruments, minimally invasive procedures and more efficient drug delivery systems to unblock blood vessels and repair tissues. This aspect of nanotechnology is especially useful and can reduce the risks associated with many invasive procedures, including cardiac care protocols.
Before we delve into the journey of nanotechnology-enabled breakthroughs in cardiac care, it is important to look at another story, one told in numbers, about the need for innovations in cardiac care in India.
According to the National Bureau of Health in India, cardiovascular diseases, especially Coronary Heart Disease (CHD), are an epidemic in the country. The Registrar General of India reported that CHD led to 32 percent of adult deaths in 2010-2013. And that’s not all. Chances are that even these staggering numbers of CHD sufferers, especially from rural India, may be underreported.
Clearly, a deadly cocktail of genetic, environmental, and lifestyle factors is choking India’s arteries. But the scenario is not all bleak.
The first bit of good news is that, because of the huge role lifestyle plays in heart disease, small changes such as giving up smoking may significantly lower risk factors. The other is that, with advances in technology, especially in the field of nanomedicine, opening blocked arteries is getting safer and more effective than ever before. The journey of the revolutionary Sirolimous-coated catheter paints a vivid picture of the coming change.
Angioplasty is a procedure to open narrowed or blocked coronary arteries, which supply blood to the heart. During an angioplasty, a balloon catheter is guided into the affected artery; the balloon may be ‘blown up’ a few times to widen the diameter of the artery.
Often a coronary artery stent, a small, metal mesh tube that expands inside the artery, is placed during or immediately after angioplasty to help prevent the artery from closing up again. A drug-eluting stent, now the norm, has medicine embedded in it that helps prevent the artery from closing in the long-term.
So far, so good. But this is where we run into a hiccup. One of the biggest problems with current drug-eluting stents is Paclitaxel, the very drug they carry. Clinical trials show toxicity associated with Paclitaxel and increased chances of thrombosis, a dangerous event linked with heart attacks and strokes. Cardiologists remain conflicted over the use of Paclitaxel.
A possible solution to Paclitaxel could be an alternate, safer drug, which is small enough at the molecular level to be bioavailable and can also be introduced in the artery in a short span of 35-40 seconds. Keep the stent in the artery any longer than this razor-thin span and you risk complications. Sirolimous is one such drug, but the biggest problem with Sirolimous is that it is slow on the uptake.
It took years of research by a dedicated core team of doctors, surgeons, pharmacists and chemists to finally put together the puzzle. And when all the pieces locked in place, the answer was perfect in its simplicity – a nanotechnology-enabled polymer-free drug-eluting stent system, especially adapted to carry Sirolimous, a far safer and hypoallergenic drug than Paclitaxel.
Though Sirolimous is typically slower and tricky to cast, the specialised stent, which has a large surface-to-volume ratio, increases the bioavailability of the drug.
Nanotechnology has very exciting implications for life-saving and lifestyle enhancing procedures, such as angioplasty. Sirolimous-coated catheters can significantly improve the chances of recurring blockages and improve the patient’s quality of life, and have shown extremely favourable results so far in small clinical trials.
With more and more people in their 40s and 30s, and sometimes even 20s, suffering from heart disease, providing a long-term solution for blockages is becoming increasingly important. The Sirolimous-coated balloon catheter has been very favourably received in the West, especially in Nordic countries. And cardiac care is just the beginning of its applications: these catheters can also be used to alleviate some of the complications of common lifestyle diseases, such as diabetes.
In 2016, this innovation in developing the Sirolimous-coated balloon catheter was recognised by Marico Innovation Foundation, the CSR arm of Marico Limited. Platforms such as these are critical in raising awareness about insights and innovation transforming lives in India. Breakthroughs in scientific innovation take a concept and make it reality; awareness is the key factor which brings that reality home to everyone who can benefit.
Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the views of YourStory.