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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Operated Angioplasty, Metal Stent Inserted, Suffered From Peptic Ulcer. On Ecosprin. Go For Bypass?

My father age of 65 Yrs, Operated angioplasty (metal stent in LAD -99 % ) by 2009, Suffered from peptic ulcer by 2012 due to ecosprin then followed by clopidogrel till continue. Again angiogrphy done by April,2013, result into ISR (in stent restnosis), suggested Dr for medical stent. Knowing from various case study both Metal & DES stent are failed after certain period. can we go with Bypass at this time Or can you please suggest me.
Fri, 11 Oct 2013
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General & Family Physician,  's  Response
Hello dear!

This is Dr.Suleman , Well dear friend deciding Stent VS Bypass is not that simple as it seems. let me explain how you decide between these two.

ByPass (called as CABG) is very lengthy and dangerous procedures. We have to open full chest and will stop heart for sometime and will perform surgery. Due to its this lengthy and dangerous procedures researchers started Interventional procedures like STENT and angioplasty.

The only problem with Stent is that recurrence of disease as comparatively high than bypass. this is the price you will pay for less risky procedure. but doing angioplasty one more time is still not as risky as single time Bypass. So if number of blood vessels which are blocked to heart are not high in number than STENT is always better than Bypass. but if more blood vessels to heart are blocked than Bypass is a better option.

Now I suggest you that please do angiography one more time and if the blood vessels which are block are less in number than do STENTS not Bypass. as i explained Bypass is a risky procedures especially at this age. and I have seen so many patients on my ward who underwent Bypass surgery and still they got the disease again. so its all about good control of risk factors which causes the heart disease.
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Operated Angioplasty, Metal Stent Inserted, Suffered From Peptic Ulcer. On Ecosprin. Go For Bypass?

Hello dear! This is Dr.Suleman , Well dear friend deciding Stent VS Bypass is not that simple as it seems. let me explain how you decide between these two. ByPass (called as CABG) is very lengthy and dangerous procedures. We have to open full chest and will stop heart for sometime and will perform surgery. Due to its this lengthy and dangerous procedures researchers started Interventional procedures like STENT and angioplasty. The only problem with Stent is that recurrence of disease as comparatively high than bypass. this is the price you will pay for less risky procedure. but doing angioplasty one more time is still not as risky as single time Bypass. So if number of blood vessels which are blocked to heart are not high in number than STENT is always better than Bypass. but if more blood vessels to heart are blocked than Bypass is a better option. Now I suggest you that please do angiography one more time and if the blood vessels which are block are less in number than do STENTS not Bypass. as i explained Bypass is a risky procedures especially at this age. and I have seen so many patients on my ward who underwent Bypass surgery and still they got the disease again. so its all about good control of risk factors which causes the heart disease.