During a cardiac cath if a blockage is discovered, can they put a stint in without having to do a bypass at the time of the cath? Of course unless the blockage(s) are too severe then a bypass would be necessary. I am thinking in the right direction?
You always have the option of having stents implanted rather than bypass surgery (this should be discussed with you by the cardiologist prior to the catheterization and proper paperwork should be filled out and signed by you before you go in for the catheterization), however, if the stent/s do not hold once implanted (they will know this immediately), bypass surgery would be the next step.
Yes, bypass surgery would be performed immediately after the catheterization, if the stent does not hold.
Even with severe blockage, stents can be implanted. I've had four, one of which was implanted in a 98% blocked artery. That stent held, even with the severe blockage, and I've had no further issues with that or any of my other three stent implantations.
I'm not sure what you mean by 'too severe'? are you referring to the size of the blockage
across the vessel as in 50% upwards? If a blockage is less than 70% it is quite safe
to leave it alone because there is a huge reserve in the coronary artery sizes. If you have
a blockage of 50% for example, it is likely that you will not notice. I worked as a labourer in the building trade and for years I did very heavy tasks while my LAD formed a 100%
blockage. Stents have a small percentage chance of collapsing and so it is unlikely you
would require a bypass if just a few stents are required. If your arteries look as though
a bucket full of stents would be required to open a vessel then you will not be given a
choice, you will be given an endarterectomy followed by a bypass. No Cardiologist will
be silly enough to insert 20 stents into a vessel.
15 stents is a lot, but I have heard there are people who have more than 20.
Before making a decision on treatment, you will have to go to the cath lab anyway for analysis of the problem. Than the cardiologist will decide if it is best solved with a stent or that bypass surgery is preferred.
They will never decide to put in 15 stents in one go, but when, every time you come in, they detect one or a few isolated stenoses, they can decide to solve it with stents and so it slowly adds up.
Looking back, you perhaps would have been better off with bypass surgery at the start, but also cardiologists can not foresee the future.
Every stent has a risk of becoming clogged. 15 stents give more risk than 1 of course. It also depends on the length, position and diameter of the stents etc.
In my opinion you are quite safe if you keep taking your blood thinners and try to keep a healthy lifestyle.
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