My mother, age 59, had an ischemic attack recently (Trop T test positive, CPK-MB elevated). She has had a BMV for her mitral stenosis two years back. She is currently in the ICU, on medicinal therapy (anti-thrombotics). She underwent an angiogram yesterday (report and video attached). Her RCA is 100 percent chronically occluded. LDA and LCX have 70 percent and 90 percent occlusion respectively.
I have the following questions: 1. What's the chance that angioplasty can help the total occlusion in her LCX?
2. Will a newer technology like Rotablator/IVUS increase chances of clearing the totally occluded artery?
3. We are in a center that does not have surgical facilities so a bypass surgery will require shifting her to a another hospital. How safe is it to do angioplasty in this situation? And would you consider it risky to shift her to a bigger city? That will involve 2.5 hours of road travel (after which we can wait ) followed by a 1.5 hour long flight?
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I am sorry to hear about your mother's poor health condition.
1. There is a very good chance that angioplasty can help with the 100 % blockage alongside a stent. She is still young. If she can adhere to lifestyle modifications and medications it will help.
2. Rotablator or IVUS can definitely help with clearing the clogged arteries. Although they also will require stenting because the site of the clogged arteries have become weak and will require stenting as support.
3. In situations like this I advise angiography for my patient. The recovery period is shorter and patients are able to live a quality life with modification of lifestyle and medication. It is not safe for her to undergo the stress of traveling at this time.
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