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Indications & Contra Indications   arrow

Indications

1.   Patients with angina equivalents who:

  • Are considered inoperable or at high risk of operative / interventional complications.

  • Suffer from micro vascular angina (cardiac syndrome X)

  • Have coronary anatomy unsuitable for catheter-based or surgical revascularization.

  • Have co-morbid conditions / illnesses that increase the risk of revascularization procedures (e.g. Diabetes, heart failure, pulmonary disease, renal dysfunction)

  • Have Left Ventricular Dysfunction (LVD) with an Ejection Fraction <35%

  • Are unwilling to undergo additional invasive revascularization procedures.

  • No longer respond to medical therapy.

  • Restrict their activities to avoid angina.

  • Cannot afford angioplasty and bypass surgery


2.   Patients who have suffered / suffer from myocardial infarction (heart attacks)

3.   Heart Failure patients who:

  • Have ejection fraction of <40%

  • Have ischaemic or idiopathic cardiomyopathy

  • Have co-morbid conditions that increase the risk of complications of revascularization procedures.

  • Diabetic patients who have a greater risk for post-procedural complications. (due to small vessel disease)

  • Elderly patients at high risk for morbidity and mortality associated with invasive coronary interventions


ECP can also be performed on patients who want to undergo treatment as a prophylactic (preventative) procedure to ensure a healthy lifestyle.


Contraindications

  • Severe arrhythmias

  • Bleeding diathesis

  • Active thrombophlebitis

  • Severe lower extremity vascular occlusive disease

  • Presence of a documented aortic aneurysm requiring surgical repair

  • Pregnancy

  • Severe pulmonary hypertension/oedema (pulmonary artery > 50 mm Hg)

  • Uncontrolled systemic hypertension (> 180/110 mm Hg)

  • Severe aortic insufficiency

  • Warfarin therapy with INR>3.0