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Which is a better option to choose from thallium stress test or Angiography ?

Hello Doctor, First of all Thanks in advance for listening to my issue and trying to provide a clear answer. My had angioplasty 10 years ago, he had 3 blockages ( 70,80,100) - Doctor at AIIMS chose to put stents in arteries with 70 and 80% blockages and left 100% untouched. Now some 4 months ago my father felt bit of uneasiness and after doing another angiography - it seems the situation is same more or less. However now again he feels some easiness - this time Doctor recommended Thallium stress test - for which our confidence level are not very high - the query is Is it better and more conclusive then Angiography ? And considering all other factors what should be the further testing diagionsis ?
Asked On : Tue, 1 May 2012
Answers:  2 Views:  399
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Gastroenterologist, Surgical 's  Response
Angioplasty has afairly fixed period of therapeutic effect. Once this effect wears out the next option is stenting. But stenting is avery shortlived option as it alters the anatomy of the vessel wall rendering the vessels less amenable to a successful bypass surgery. In the present case all conservative options are exhausted , now surgery remains the best option. But this will require adequate functional and anatomical assessment. You should consult a cardiac surgeon who will be the best judge to decide the further course of action.
Answered: Tue, 1 May 2012
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Cardiologist Dr. Saeed Ahmed's  Response

Thank you for your question,

We do thallium scan in such situation to see the blockage at the micro level arteries. Angiography does not show these small arteries and person after having stents implanted and still having symptoms might be suffering from blockage to the micro arteries so we do this test to see those arteries.
If blockage is found then we proceed with high dose of statins, aspirin, clopidogrel, nitrates, beta blockers and ACEi.

I hope this helps you to understand why the doctors are doing this test.
Good luck.
Answered: Tue, 1 May 2012
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