stents for left circumflex near main artery intersection

[edjewels]

I have been diagnosed with a blockage in the left circumflex close to the intersection with the main. I am concerned , as is my cardiologist about the cath procedure being a success. I have had one cath proceedure to fix a simple block in the LAD artery and feel much better since that was don. Has anyone had any experience with a stent repair to a block in this location. What has your experience been

[nannyitt]

I had a 84% blockage at the entrance of the circumflex artery.  My cardiologist told me putting a stent there was a difficult procedure because chances of a heart attack was high, but without the stent my condition would get much worse.  He said he was not experienced enough to do the procedure with complete confidence and would understand if I wanted another doctor to perform the procedure or not do it at all.  Of course I would do the procedure, and having complete trust in my cardiologist, I asked him  do the procedure.  All went well with the procedure and it has been four years now. without any problems.  The chance of living a near normal life compared to the possibility of death was obvious. Following the doctors instructions on diet and exercise plus of course meds is  important.  But I have no regrets, only gratification and a great doctor.    

[JONKEL]

I have a very similar problem  to yours a blockage in my left circumflex . i was told nothing would be done ! as a result i have really bad angina and have to take GTN tablet form every day . It makes me light headed most of the time I'm just sick of medication all the time . Hope everything works out for you  and get back to a normal life .JON

[edjewels]

Thanks to both of you for your responses to my question regarding the catheter procedure involving my left circumflex artery.
Let me say this to you both, I have the utmost confidence in my cardiologist and his skill level for this procedure.
My doctor assured me he is very comfortable, after a lot of thought, research, consults with coleagues, and discussions with his team, to go  ahead with the repair this blockage.
He said 2-3 years ago he would probably have referred me for by-pass but now the equipment is available to do this and his experience with this kind of repair being extensive make this doable.
His reputation around the cardiac community, nursing staff and other patients is top notch.
My impressions of his skill and knowledge have been consistently very positive. I understand that there are risks but I am going to move ahead and have the cath procedure.

I thank you again for your imput and I wish you both the best of luck with your conditions.
I will let you know how it goes.

[kenkeith]

In addition to what Ed has said, I will provide more information with an insight to difficultly of stenting.

I have a totally blocked LAD and 70% blocked  ICX close to the bifurcation. For an idea the configuration resembles a "Y" and as the blood flows from the main into both branches there is some turbulance and shear stress of the blood flow that is a major underpinning for blockage.  The problem with bifurgation is a stent with one blockage impinges the diameter of the opposing vessel. .

There is a procedure called T-stenting that is simple and technically less demanding. But successful stenting of a bifurcation should have an angulation of more than 70 degrees if I remember correctly. And the size of vessel is also a condideration.  Smaller opposing vessel and its distribution area may be less or more significant, etc.  

So the variance of configuration, size and its blood distribution would be the overriding significance as well as the skill of the cardiologist before going forward with a stent.

Thanks for your question and if you have any other questions or comments you are welcome to respond.  Take care.

[ed34]

My 100% blockage was in the top of my LAD, right next to the bifurcation of the LCX. It was over an inch long and on a curve, making it so risky that I couldn't find a cardiologist willing to attempt it for two years. The key is how hard the material of the blockage is. If they cannot get a wire through the mass to the other side, there's no way the blockage can be removed. When putting pressure on the catheter wire, there's a huge risk it will shoot off to the side and pierce the artery wall, and this will be game over. In nearly all cases, the artery tears all the way down, killing you. I had the best cardiologist in the country and the wire went halfway into the wall, I was literally scared to death. I would strongly urge you to consider bypass first. I had this done but mine unfortunately failed after 3 months, making angioplasty the only option.
I would seriously give this strong thought because it's not the kind of procedure I would want a cardiologist with little experience doing on me.