April 30, 2014 | At a catheterization lab in Coimbatore, India, Dr. Mathew Cherian uses innovative 3D imaging equipment and high-tech minimally invasive techniques for several medical emergencies.
Text: Dr. Natasha Das
Photos: Thomas Steuer
Management Summary
Challenge:
Travelling 300 to 500 km to Vellore or Chennai for interventional radiology procedures added to the steep cost of treatment. Time was also a crucial factor. Open surgery was less costly but needed more recovery time and had more complications.
Solution:
Dr. Cherian uses state government aid and technology from Siemens to bring vascular and neurointerventional solutions to the people of Coimbatore and the nearby towns and villages.
Result:
At the center, Dr. Cherian has saved thousands of lives through tiny skin punctures. This has reduced the travel time, the costs, the recovery time, and the risks of complications, helping patients to be back at work within a few days.
Few people in India had heard of interventional radiology when Mathew Cherian, MD, started the Department of Interventional Radiology and Imaging Sciences at Kovai Medical Center and Hospital (KMCH) in 1991. KMCH is an 850-bed hospital in Coimbatore, in the state of Tamil Nadu in India with Dr. Nalla G. Palaniswami as its Chairman.
In its early years, KMCH had a Siemens Coroscop/Hicor single plane cardiac catheterization lab that recorded images on a 35mm cine film. Cherian’s team mostly focused on diagnostic imaging and performed diagnostic angiograms, basic angioplasty, embolization of tumors, and hemoptysis management.
Advantages of the Biplane System
Today, KMCH’s cath lab has a Siemens Artis® zee biplane system with Large Display and syngo® DynaCT allowing 3D angiography and simultaneous CT-like scanning with greater precision. The highly-flexible positioning allows Cherian to plan and execute perfect working angulations for all his interventional procedures. He is able to manage more complex aneurysms and arteriovenous malformations than ever before. In addition, he treats bleeding from the smallest vessels in the intestine and stenoses in the blood vessels of the legs. The Department also uses this technology for nonvascular interventions such as biliary stenting, fallopian tube recanalization, and radiofrequency ablation of tumors.
Dr. Cherian’s biography
Dr. Mathew Cherian, Head of Radiology at Kovai Medical Center & Hospital, has more than 20 years of experience in interventional radiology. He obtained his MD in Radiology from JIPMER, Pondichery, following which he did a postdoctoral course in interventional radiology at Sri Chitra Tirunal Institiute of Medical Sciences, Trivandrum. He joined KMCH as a consultant in radiology in 1991. Dr. Cherian was medical advisor for Boston-Scientific and Johnson and Johnson, USA. He is a proctor for Boston Scientific for the development of interventional radiology in South East Asia. He has pioneered interventional radiology in this part of the country and is the founder of CO2 angiography in India. He has developed a dedicated team of interventional radiologists who routinely perform a spectrum of interventional procedures ranging from treating aneurysms in the brain to opening blocked blood vessels in the limbs.
“Success is about Comprehensive Management of the Patient”
These minimally invasive techniques are often done percutaneously (through a skin puncture). They cause less pain, require less recovery time and have often lower complication rates than open surgery. In most cases, the patient can be discharged within a couple of days.
“Success is not about doing an intervention well; it’s about comprehensive management of the patient,” believes Cherian. KMCH provides multiple solutions under one roof as an apex center for cardiac care, laparoscopic surgery, and kidney transplants. It also has a comprehensive cancer center.
Improved Access to Interventional Radiology in India
Chennai and Vellore are the nearest cities with this kind of healthcare service. Chennai is around 500 kilometers (km) away. A bus ride takes nearly 10 hours. Vellore is closer at 320 km. The travel takes six to eight hours. KMCH is, thus, a boon to the people living in and around Coimbatore.
The initial capital investment costs and the limited number of trained interventionalists are the main barriers to the wide use of such technology in India. With the facility provided by the Kovai Medical Center, Dr. Cherian and his team of doctors make these world-class health solutions accessible to the people of Tamil Nadu and the nearby states. The state government provides health coverage for these interventions for patients in need. It has also recognized KMCH for training in interventional radiology and two fellows are selected each year to train under Cherian.
Making Patients Smile
Each day, Cherian’s team of doctors performs about four procedures, some of which are completely supported by the government. Industrialists and other citizens also help. For those who can afford it, KMCH has several higher categories of rooms and suites. The king’s suite on the sixth floor with four rooms and a sprawling terrace garden gives a luxury hotel-like experience.
“There is no need for a hospital to look sad. Our walls are brightly colored. There are beautiful paintings hanging on them,” says Cherian. “Thanks to the government aid and the technology we use, I am glad we are able to use the best of technologies to bring a smile to the poorest of the poor in India."
Author’s Bio
Dr. Natasha Das is a physician based in Delhi. She is a freelance medical writer, editor, and medical writing trainer. She conducts peer review of manuscripts submitted to biomedical journals. She is also secretary of the All India Medical Writers Association (AIMWA).
