Angioplasty Standby

[Stefanus]

I recently had an angioplasty procedure performed, but it was not completed. The Dr performing the procedure said I need further investigations, ie, an MRI Stress test because of. Here is the report they gave me.

Managment Plan:
Depending on the result of MRI, may require PCI of circumflex and LAD, or CABG.

Is this an indication that two or more of my arteris are blocked. Since the angiogram, I frequently get minor chest pains without stress.

Thank you

[kenkeith]

I agree with Ed.  There is confusion..

[kenkeith]

Thanks for the feedback. You are referring to collateral vessels, and it is a phenomonon that gradually develops and feeds into the area deficit of the normal blood supply from the occluded (partially or complete).  As stated in my prior post I have collateral blood flow.  The phenomonon occurs for some individuals and not others.

The Plavix is an anti-platelet medication to help prevent blood clots. I and many other individuals have been on Plavix and aspirin for up to a year after a drug eluding stent inplant (with DES there is a risk up to about 1 year for a blood clot at the site of the implant) however, after a year many just stay with aspirin and off plavix...recommended after government studies...,risk of excessive bleeding outweigh any benefits if any.  My brother-in-law was on Plavix and a fall from a ladder and slightly striking his head caused uncontrolled bleeding in the brain and never recovered. Someone else would have a headach and nothing serious.  One can bleed internally from an ulcer, bowel, etc. without knowledge until it is too late.  Did your doctor tell you why you are on Plavix?

[ed34]

Ok, now I'm really confused here. They did an angio-something, then did no stenting or any intervention, but they then put you on Plavix?  

[Stefanus]

Thank you for your replies. The angiogram was completed, but with no definite plan of action untill the MRI Stress is completed. There has no date been set for it. The two arteris in question. The blood has found a new route, so I should imagine that they are well and truly blocked. I am on medication for HB, cholestrol and a new one named Plavix (Clopidogrel) for at least 12 months, or till a decision has been made. The waiting time is quite un-nerving to say the least...

[kenkeith]

For some insight:  Angioplasty with or without vascular stenting is a minimally invasive procedure performed to improve blood flow in the body's arteries and veins, and involves imaging techniques to guide a balloon-tipped catheter, a long, thin plastic tube, into an artery or vein and advance it to where the vessel is narrow or blocked. The balloon is then inflated to open the vessel, deflated and removed. Then a small wire mesh tube called a stent may be permanently placed in the newly opened artery or vein to help it remain open.

There was an aborted angioplasty and now an MRI stress test is considered. There is a difference between an angiogram and angioplasty. Angiogram is a diagnostic procedure! Angioplasty is therapeutic meaning treatment.

Usually, or almost always the diagnostic procedure (angiogram) is performed before there is treatment.

[ed34]

Did they by any chance say HOW blocked they are in the angiogram? what percentage?

[kenkeith]

For some insight, the circumflex and LAD branch away from the left main artery (a "Y" on its side if you will). Usually, a stress test is given prior to angioplasty, and a decision may be made at that time for the appropriate treatment. Only your doctor can answer why the angioplasty was terminated prior to implanting a stent!  

Are you taking medication for your chest pain? What are your symptoms other than chest pain?  Why is medical therapy not included as an option.

I have a totally blocked LAD and circumflex is 72% blocked and I do well with medication for the past 6 years.  All you got is a management plan?