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Do I need angioplasty?

Thursday, 29 June 2006
Answered by: Dr. O.P. Yadava
Consultant Cardiac Surgeon, CEO
National Heart Institute and Research Centre
New Delhi
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Q. I am 72 years old and have a 100% blockage in the right artery and two 30% blocks in the left arteries. I have no symptoms as such. My TMT and 24 hour ECG is normal. The medications being taken are Deplatt 75, Losar 25, Storas 40 and Nitrocontin 2.6 twice daily. I am a diabetic with controlled levels. Do I need angioplasty?

A.  I am afraid, I do not have sufficient details to give you a clear cut answer but in general if the angioplasty is relatively simple one with a localized block in the artery, then possibly an open artery is always better than a closed artery and angioplasty may be desirable. Obviously presuming that you have no financial difficulties in undergoing this angioplasty. However, if your artery is diffusely diseased or if the block is located in the lower portion of the artery, specially because you have no symptoms and your TMT is negative, then you can manage it with medications also because long term survival benefits have not been demonstrated with interventional techniques over medical therapy. However, I repeat, such advice can only be given after interrogating the patient in detail and after having viewed the angiography and this advice is being given more on a general and casual basis and should stand superceded by the advise of your treating cardiologist.

A.  I am afraid, I do not have sufficient details to give you a clear cut answer but in general if the angioplasty is relatively simple one with a localized block in the artery, then possibly an open artery is always better than a closed artery and angioplasty may be desirable. Obviously presuming that you have no financial difficulties in undergoing this angioplasty. However, if your artery is diffusely diseased or if the block is located in the lower portion of the artery, specially because you have no symptoms and your TMT is negative, then you can manage it with medications also because long term survival benefits have not been demonstrated with interventional techniques over medical therapy. However, I repeat, such advice can only be given after interrogating the patient in detail and after having viewed the angiography and this advice is being given more on a general and casual basis and should stand superceded by the advise of your treating cardiologist.

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