70% Magic Number?

[bardon123]

I had two arteries blocked at 100% and stents implanted in October, 2009 at a hospital in a nearby community.  Yesterday I had another angiogram done in my community by my cardiologist, and he said that I had 60% blockage in the two arteries that were stented, and the stents installed, were undersized.  He said I would need to wait and they would do another angiogram in a couple of years to check the blockage.  I've heard the number 70% upon many occassions and it seems to be the "magic" number for any angioplasty or stent work.  Why is 70% the magic number before they will or can perform any arterials bypass type of work?  Now it just seems like I'm in a "crap" shoot waiting for two years or a heart attack which ever comes first.

[kenkeith]

The 70% blockage is a guideline by the AAC./AHA. Based statistically, it may be the percentage of heart occlusion problems that causes symptoms, but it is an estimate and doesn't represent individual specifically.  My doctor is a non-interventioanal cardilogist and treats angina caused by vessel stenosis with medication.  I have had an occlusion greater than 70% for years and medication prevents any symptoms.

If medication does not effectively prevent symptoms, then according to guidelines do a stent implant, if unable to stent then bypass. The guideline is more symptom oriented than occlusion size.  Medication can open vessels, stent can brace a wider opening and bypass will effectively relieve angina structually. There maybe intevention in the event of an emergency...no choice.  

[ChatterAlly]

I am feeling the same way.  I have a 50% blockage in an artery they say they cannot stent, so in my case I would rather wait and just take the meds and etc.  I do not want cabg.

[ed34]

The line has to be drawn somewhere to establish if a procedure carrying risk should be performed or not. 70% was chosen because anything less can be treated (in nearly all cases) with medication. 70% and above does pose more risk of rupture and symptoms not being controlled by medication. I too was amazed at this when told by my cardiologist, but he said nearly all patients with a 60% blockage don't even know it's there. The arteries are much larger than they need to be, giving a huge reserve. For 2 years while cardiologists were trying to decide my fate with surgical options, my left artery had a 3-5% feed. This was all the left side of my heart had to try and function. I was gardening, carrying shopping, walking over a mile every day. All thanks to medication.