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Angiography report. Suggested for an angioplasty. Is angioplasty required or can be treated with medications?

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Hi: My father went through angiography yesterday. I have uploaded his report on the next page. The treating doctor has suggested to go for an angioplasty. Could you please suggest if angioplasty is actually required or if it can be treated with medicines?
Posted Fri, 15 Jun 2012 in Hypertension and Heart Disease
Answered by Dr. Ravindra L Kulkarni 36 minutes later

Thanks for the query.

As per Angiography report:
1. There are multiple arteries involvement.
2. Two critical lesions in Left Anterior descending arthery (LAD - ostial and mid) distal diffuse involvement is seen.
3 Left Circumflex having proximal critical lesion along with diffuse distal disease (Diffuse alcohol intervention) is needed
4 mild disease in Right cerebral arthery.

As per this reports, your father definitely needs intervention in order to stabilize and improve blood supply to heart .

Considering multiple lesions in all 3 branches - bypass surgery will be preferred option. Do discuss this with your treating cardiologist and also consider to have cardiac surgeon also.

Other Option of angioplasty can be considered with following issues

1. as it is Ostial LAD lesion , it will be high risk stent procedure . It can be performed at good set up with cardiac surgery option stand by .
2. As LAD had 2 lesions , we will need to deploy 2 stents - preferably Drug coated . But still distal diffuse disease will have impact on outcome of revascularization .
3. Same thing also apply to LCX , as there is diffuse distal disease .
4 If institute has facilities like IVUS or FFR are available , then it definitely helps cardiologist to identify critical lesion and proceed with angioplasty . IVUS or FFR are newer technologies which asses blockages better than visual images of Angiography .
So with multiple stents , angioplasty can be considered with high risk .
Bypass cardiac surgery will be an elective procedure and will have less risk as compared to angioplasty and will have better long term outcome in terms of symptoms and quality of life .

Hope this answers your query. Please feel free to discuss both the options angioplasty and bypass surgery with your treating cardiologist . please feel free to ask any more queries if you have .

Wish your father a good health and speedy recovery .

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