Heart Disease Expert Forum
do I stent?
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do I stent?

My right coronary artery is 90% blocked.  calcified.    I have had no discernible symptoms.   I walked and was active.  I could find no data to tell me whether stenting this artery will improve my chances of avoiding a future heart attack, although it seems to be common practice to stent at this level of blockage.  My cardiologist said it could collapse.    Is there hard data to indicate stenting is the right course?  

thanks      
2 Comments
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Avatar_m_tn
yes, it  will improve your chances. If you don't stent  the blockage could worsen. I was stented three years ago at age 82. RCA 95% blocked. A 24-hour Holter two months ago showed paroxistic supraventricular tachycardia. Rythmol has now been added to Coreg 6.25 daily. that's just my bad luck. It has nothing to do with the stent as far as I know. I do up to an hour aerobics - bike, run/walk six days a week. best wishes
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Avatar_dr_m_tn
Without being able to fully review your heart catheterization images, it is difficult to say how significant this lesion may be (sometimes the right coronary artery is nondominant and very small in caliber and calcified areas may cause the lesion to look worse than it actually is).  The fact that you do not have symptoms indicates that this lesion MAY not be clinically relevant.  There are other ways to determine if a stent would be helpful rather than just looking at the images angiographically.  Doing a test during the catheterization called FFR (fractional flow reserve) or IVUS (intravascular ultrasound) can reveal if a narrowing in a coronary artery is actually causing blood flow limitation and if a stent would be helpful (these modalities are supported by a lot of data/research and are part of the national guidelines for coronary disease).  Discussing with your physician whether this is actually a flow limiting lesion may be prudent.
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