Heart attack patients at the Royal Free Hospital in London are the first in the country to be treated with an artificial intelligence backed keyhole procedure.

The pioneering technology coupled with AI means cardiologists are able to make quicker and more accurate decisions while carrying out angioplasties – fitting a stent - for coronary artery disease.

Having treated thousands for COVID-19 during the pandemic, The Royal Free Hospital will now be able to get routine services back on track with procedures like these which offer enhanced treatment than before the pandemic.

Abbott Ultreon 1.0 software merges optical coherence tomography (OCT) – an existing imaging tool that provides cardiologists a comprehensive view inside an artery or blood vessel – with the power of AI for enhanced visualisation.

The AI software can automatically detect the severity of calcium-based blockages and measure vessel diameter to enhance the precision of surgeon’s decision-making during coronary stenting procedures, which are used to treat patients with coronary artery disease.

Unlike traditional imaging methods such as conventional angiography, the OCT technology, created by global healthcare company Abbott, uses near-infrared light to provide high-definition, precise imaging from within a blood vessel. OCT imaging also helps improve physicians' assessment of blockages in those vessels and optimise decisions related to stent selection, placement and deployment. The merging of AI with this technology enhances accuracy and provides a valuable tool to guide the cardiologist through the procedure. 

One of the first patients to benefit from the new software is Adam Adamou, 76, from Winchmore Hill, Enfield. Adam suffered a heart attack while he was in the Royal Free Hospital receiving treatment for a severe urinary and prostate infection earlier this year. He was immediately treated in the hospital’s heart attack centre and underwent an angioplasty procedure – where a stent was placed in his artery to open up the blockage. After recovering at home he returned to the Royal Free Hospital to undergo elective surgery for a planned second angioplasty and this time the procedure included the new AI element.

Both procedures were carried out by Dr Sundeep Kalra, a consultant interventional cardiologist at the Royal Free London NHS Foundation Trust. Dr Kalra was joined for the ground-breaking second procedure by Dr Jonathan Hill, consultant interventional cardiologist at the Royal Brompton and Harefield NHS Foundation Trust. Dr Hill is one of the global experts in OCT, the imaging tool that provides doctors with a comprehensive view inside an artery or blood vessel. The new AI software which has been merged with the OCT now allows doctors to automatically detect and quantify blood vessel characteristics, giving them better insights into optimal patient treatment.

Over the coming weeks a further 20 centres across the UK will receive this new, enhanced AI software upgrade, which will allow cardiologists to have a more precise and measurable way of supporting patients undergoing coronary stent procedures.

Now recovering at home Adam Adamou, said: “I’m looking forward to getting back on the golf course now I’ve had the procedure. That’s my goal – it’s the love of my life, alongside my wife! My health has not been good for some time and my wife had to give up her job as a respiratory physiologist – coincidentally at the Royal Free Hospital – to take care of me. We both feel very strongly that the more people that can benefit from this new technology the better. I always felt very reassured I was in safe hands.”

Another Royal Free Hospital patient who has also just benefitted from a second stent with the support of AI is Vina Khatri, 61, from Whetstone, Barnet. She had her first stent fitted a month ago after she complained of chest pains. Her family called 999 and she was taken by ambulance to the Royal Free Hospital heart attack centre.

She said: “It’s a relief to have had the second surgery, which was planned. Now I just want to get back to enjoying a normal life, especially playing with my four grandchildren. Everything was really well explained to us and anything that helps the doctors do their job is fantastic.”

Dr Sundeep Kalra, said: “As with other hospitals up and down the country the Royal Free London’s capacity has been stretched throughout both waves of COVID-19. Indeed, we were one of the worst affected trusts in the country, with cardiology facing a particularly heavy burden. In spite of this we’ve not only been able to dig deep and continue our elective percutaneous coronary intervention (PCI) programme in a COVID-safe pathway, but have also continued to innovate during this time of clinical pressure. 

“As well as developing two state of the art catheterisation lab installations, we’re also very pleased to now be able to introduce the new Ultreon 1.0 software to pre-existing hardware in both labs. We are one of the highest volume OCT centres and look forward to leading on the use of Ultreon for AI guided PCI. Going forward this will enable more cardiologists, thanks to the enhanced visualisation and guidance, to carry out a procedure which until now has been limited to a few specialists.”

"Increased adoption of OCT imaging, when combined with advanced technology like AI, allows cardiologists to have a more precise and measurable way of supporting patients undergoing coronary stent procedures," said Nick West, chief medical officer and divisional vice president of global medical affairs at Abbott's vascular business. "Ultreon Software can potentially improve physician and patient experience by utilising a systematic process, reducing variability and increasing accuracy of diagnosis and application of therapies."

(PIC L-R: Dr Kalra, Dr Hill and Adam Adamou)