Surgery for artery blockage

Hello Doctor,
This question is a little off the topic because there was no topic identified in my category but I think you very well may be able to answer it.  The question requires a little bit of explanation first. My husband has a blocked artery in his groin area and will require laser surgery as was recommended by our doctor in McAllen, Texas.  Since contrast dye is used in this surgery and it is bad for the kidneys, (my husband had one kidney removed ten years ago because a doctor erroneously removed his kidney thinking it had cancer although it was a rare infection that mimicked cancer), my husband did not have the surgery.  The question is this:  is there some alternative route we could take to have this surgery without contrast dye?  We would also ask if there is something we could do aside from diet, exercise and not smoking that would take care of this blocked artery?  Sorry for the long question but I didn't have any other way of asking that I thought would make sense!  Thanks!

[Michael J. McWilliams, M.D.]

is there some alternative route we could take to have this surgery without contrast dye?

It depends on which artery it is.  Some of these arteries can be bypassed surgically rather than with catheters, but contrast dye is usually required to make the diagnosis.  An MRI with GAD (does not affect kideys) would help localize the blockage if they do not already know where it is.  

If his kidney function is normal in his remaining kidney, contrast dye can be safely used.

Another option is get  a second opinion from an academic center.  They tend to be more on the cutting edge of newer technologies and they are often salaried, so if there are better options you don't have to worry about confounders in the decision process.

If the kidney function is not normal, careful hydration and N-acetylcysteine prior to the procedure can reduce the risk of renal failure with contrast dye.

We would also ask if there is something we could do aside from diet, exercise and not smoking that would take care of this blocked artery?

Hopefully you are already doing the diet, exercise and ABSOLUTELY no smoking.  There are medications that reduce atherosclerosis -- statins --that he hopefully  he is already taking.

I hope this helps.  Good luck.