is coronary angioblasty is safe?

[churchill2]

is coronary angioblasty is safe?

i really want a detailed and definite answer ,plz

[Hero]

It depends upon the patient's condition. Obviously it has yin and yang. Tell me the patient's history including lab values.

[churchill2]

the patient is 57 yrs old man suffering from hypertension and diabetes

[Love Nepal]

hi,
Of course coronary angioplasty is safe and thats why it is so popular these days.There has been a slight concern about the medicated stents recently but all in all its a safe procedure.Compare it with the morbidity and mortality of CABG and u will know the difference.
But to conclude whether one needs it or not and whether or not it is better suited that CABG we need to look at various things.First and foremost being the number of vessels involved (sigle,double or triple vessel disease),the site of the involvement in the vessels and other co morbid conditions.
Generally in double and triple vessel diseases with significant blockages CABG is preferred (sp.with TVD) and also in the case of Left main significant blockage.
We have to see the co morbid conditions too,I guess in diabetes CABG is preferred but its not a hard and fast rule.

This is just a run down from what i remeber,so please check the info before deciding.And if you are asking this because it has been suggested by a doc on one of your relatives,then just go by what the doc says.....trust his judgement.

[Hero]

Love nepal already gave u valuable suggestion. Coronary angioplasty is not recommended just for hypertension and DM . Angiographic findings rather than the patient's risk factors are important for angioplasty. Coronary angioplasty is extremely safe procedure if done in a good cathlab with intra-operative mortality of less than 1%. [ACC/AHA guideline recommends operator experience of >75 primary PCI/yr, and team experience >36 primary PCI/yr]. If not contraindicated, angioplasty is the best reperfusion therapy.

[churchill2]

thank u Dr NEPAL lover and Dr hero ,

i have 2 questions
1- what is single ,double & triple vessel disease?
2-why it's not preffered for patient with DM and hypertension to have angioplasty surgery?

thank u

[Hero]

Single vessel=one vessel [RCA, LAD or LCX ], double=any two, triple=all [or Left main+RCA]
Angioplasty & angiography r different. As I said before, angiographic findings rather than the patient's risk factors are important for angioplasty. If your pt doesn't have ischemic pain (normal resting ECG, stress ECG, resting echo) then angiography is not necessary. Treat HTN and DM, look for other risk factors as well and treat them. If resting ECG is normal, exercise ECG can be done to rule out CAD. Coronary angiograhy is recommended only for pts with hemodynamic instability or for pts in whom spontaneous or exercise induced ischemia occurs. I hope u r clear now.