artery blockage at the intersection of another artery

[Tom21451]

70 % blockage in my LAD right at the intersection,( up stream) but not in the intersection, of another nice size artery. Stenting would encroach in the intersection, which could cause problems, as I am told and it makes good sense to me and if the procedure  goes ok, high risk of problems later, etc. I'm 59, good health, both parents living at home with 24 hour help, with no family heart history., except me. I had a heart attack 15 years ago, 90 % blockage right coronary, balloon  and rotor rooter, stents were not available. No trouble since, no pain, no shortage of breath to this day. All this came about starting 2 years ago when a local group got a new machine, I call it the body scanner, one of the first to do it, they wanted some people to try it as they got up to speed, showed some blockage, the decision was to watch it,  2 weeks ago, nuclear stress test showed something, last week cath, 70 % blockage.The area of 15 years ago showed no plaque build up, which was surprising to the doctors. With stenting out the plan is by pass. I know you have not seen pictures, but my question  to you, and sorry for taking some words to get to it, with blockage like this other than stenting and by pass do you use any other procedures to correct the problem and it/they have a good track record ? Surgery is scheduled May 13, so any answer, yes, no, maybe, whatever would be deeply appreciated. Tom  cell 601 594 7263    

[ed34]

I had this problem. A 2 inch total occlusion in proximal LAD, right next to circumflex branch. Distal LAD had tiny feeds but only enough for rest, not exertion. Triple bypass performed but the surgeon grafted the LIMA to the blockage, making it useless. 2 vein grafts closed up after 3 months. Imperial College London performed Angioplasty which other hospitals had said impossible. The Whole LAD was cleaned up then stented with 5 long stents. First stent had to cross over the circumflex branch but a hole was punched through the side of the stent giving excellent flow. LAD gave lots of spasms during this very long procedure and had never done this in prior 5 angio procedures. Now the left main stem feeds my LAD plus the LIMA is now free to also supply a feed. So I basically have a double feed.

[Cleveland Clinic]

I think that if your doctors found the lesion to complex to stent then bypass surgery is the only option to get around the blockage and supply the distal myocardium with good blood flow. The grafts tend to stay open longer, and to supply the myocardium independent of the native artery ( at least the proximal portion) and so they can provide a second conduit for blood to flow into the heart.