INFO REQUEST: Artery blocked at 70% : operation vs other alternatives 
Author Message
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives

Apologies if this is the wrong group.  Apologies for my lack of
knowledge in this area (I'm a computer engineer, and as if this wasn't
enough, the little I know is in French making this e-mail a bit tricky
to write).

Down to business...

My dad had an artery blocked at 70%. He got an operation (taking a
piece of artery from the leg, and using this to replace the blocked
section). RESULT: Back to square one. They still haven't fixed the
problem. (I think they where careless, but I'll skip that part).

Now he's switched doctor. They will now use some sort of "balloon"
(How is this thing call) to enlarge the artery, and then insert some
tube to keep the artery from shrinking again.

A few things that I'm wondering:

1. Why could it be a good idea to operate then, but now it is not?
Could it be that you can't operate a second time on the same artery?

2. I've heard that this "balloon" solution had only temporary success,
and that it would have to be done again. How much better is it with
the insertion of the tube? Is the use of a tube a well proven
solution, or is it just experimental?

3. What kind of risk is there with the use of a tube? Could it move?
What if it moves?

4. Any pointer to reading material?

I realise that this maybe vague, but at the moment, this is the
information I have. It isn't easy to get info from parents who are
pretty shaken up by all this...

Anyway, any info welcome. E-mail prefered, but I will keep an eye on
the newsgroup.

Thanks in advance.
--
  ,

- NORTEL -                     Tel: (613)763-9778
Bell-Northern Research / Recherches Bell-Northern



Sat, 01 May 1999 03:00:00 GMT
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives


Quote:

>Apologies if this is the wrong group.  Apologies for my lack of
>knowledge in this area (I'm a computer engineer, and as if this wasn't
>enough, the little I know is in French making this e-mail a bit tricky
>to write).

>Down to business...

>My dad had an artery blocked at 70%. He got an operation (taking a
>piece of artery from the leg, and using this to replace the blocked
>section). RESULT: Back to square one. They still haven't fixed the
>problem. (I think they where careless, but I'll skip that part).

>Now he's switched doctor. They will now use some sort of "balloon"
>(How is this thing call) to enlarge the artery, and then insert some
>tube to keep the artery from shrinking again.

>A few things that I'm wondering:

>1. Why could it be a good idea to operate then, but now it is not?
>Could it be that you can't operate a second time on the same artery?

>2. I've heard that this "balloon" solution had only temporary success,
>and that it would have to be done again. How much better is it with
>the insertion of the tube? Is the use of a tube a well proven
>solution, or is it just experimental?

>3. What kind of risk is there with the use of a tube? Could it move?
>What if it moves?

>4. Any pointer to reading material?

>I realise that this maybe vague, but at the moment, this is the
>information I have. It isn't easy to get info from parents who are
>pretty shaken up by all this...

>Anyway, any info welcome. E-mail prefered, but I will keep an eye on
>the newsgroup.

>Thanks in advance.
>--
>  ,

>- NORTEL -                     Tel: (613)763-9778
>Bell-Northern Research / Recherches Bell-Northern

It sounds like you're referring to a coronary artery blockage. The
particular artery which is 70% blocked is important to know, since
surgery is recommended for "left main" lesions, but for other {*filter*}
vessels, the choice is probably made by consideration of technical or
logistic factors (size of the vessel, location of the blockage, etc).
With a single partially blocked vessel, an attempt at angioplasty is
certainly warranted, if the blockage is causing symptoms or clear-cut
ischemic episodes.  You are correct, the main problem with angioplasty
is the recurrence rate.  It appears that the stent, put in after the
vessel is opened, may prevent the re-stenosis of the artery.  The
stents don't migrate.  Hope this helps..H2


Thu, 06 May 1999 03:00:00 GMT
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives


Fri, 19 Jun 1992 00:00:00 GMT
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives

I AM 67. I HAVE HAD 2 SUCH ANGIOPLATICS PROCEDURES SINCE FEB. AT THE LAST
I HAD A  STENT PUT IN ONE OF THE TWO BLOCKAGES. IT IS GREAT. AS LONG A
YOUR KEEP UP 1,THE EXERCISE 2.THE PROPER DIET. KEEP THOSE ARTERIES
CLEAN...REAR DEAN ORNISHES BOOK. GEORGEI



Sat, 08 May 1999 03:00:00 GMT
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives


Fri, 19 Jun 1992 00:00:00 GMT
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives

Cannot give reason why 2d operation cannot be done. Age., condition of
patient, etc.  Perhaps it is not necessary and can be done with lesser
difficulty using angioplasty (balloon) which is quite successfull
depending on location of blockage. It is true that some possibility of
reoccurence is possible.  This usually shows up within a short time, <
6mos.  However the use of the Stent in the artery will help.  This is a
small circular tube-like device that fits inside the artery and holds the
artery open.  The angioplasty and insertion of the Stent is done through
the fem{*filter*}artery in the groin and is much less invasive than the
operation you described.  Patient usually in and out the same day, and
minimum recuperation time required.   Good luck....



Sat, 15 May 1999 03:00:00 GMT
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives

My wife just recently underwent a cardiac angioplasty (balloon), this
lasted only three weeks and another angioplasty in the same artery
occurred with stent placement which lasted five weeks. Another angioplasty
was performed with limited results as balloon busted after third try. Only
70 % was able to be reversed.  Additional medicine and {*filter*} thinners were
prescribed and likelyhood of reoccurance amost certain. But since only one
artery is involved Doctors are reluctant to do bypass because she is only
just 47 years old. I am told no surgery lasts forever and as of today
there is no cure for coronary artery disease, only increments of borrowed
time.  I have heard of experiments being performed with radioactive
stents.  Here's hoping technology moves at a faster pace.  Take care



Wed, 19 May 1999 03:00:00 GMT
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives

On Wed, 04 Dec 1996 22:48:09 -0800, Tresa Rose Adkins
: My mother needed a bypass but was not a good candidate for one because
: of her fragile state.  They tried meds, but she continued to worsen.
: She recently had surgery where they took the MAMMARY artery and did
: some kind of "rewiring" in order to get better {*filter*} flow into her
: heart and help her chest pain and make her feel better -- which she
: does!  it's not as good as a bypass, but she survived it and is doing
: well.  this was done at st. joe's hospital in ann arbor, michigan.

Why do you say it's "not as good as a bypass"?  My surgeon implied that
it's the preferred choice, assuming that it can be made to reach the
affected coronary artery.  It has the advantage that it requires only
one grafted attachment, while a segment of vein from a donor site
requires two.  I had a sextuple bypass, and I believe they used the
mammary artery on the most dangerous blockage.
--  
   ___            _                                             -  Bob
   /__) _   /    / ) _   _

Robert K. Coe ** 14 Churchill St, Sudbury, MA 01776-2120 USA ** 508-443-3265



Tue, 25 May 1999 03:00:00 GMT
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives

Quote:

> On Wed, 04 Dec 1996 22:48:09 -0800, Tresa Rose Adkins

> : My mother needed a bypass but was not a good candidate for one because
> : of her fragile state.  They tried meds, but she continued to worsen.
> : She recently had surgery where they took the MAMMARY artery and did
> : some kind of "rewiring" in order to get better {*filter*} flow into her
> : heart and help her chest pain and make her feel better -- which she
> : does!  it's not as good as a bypass, but she survived it and is doing
> : well.  this was done at st. joe's hospital in ann arbor, michigan.

> Why do you say it's "not as good as a bypass"?  My surgeon implied that
> it's the preferred choice, assuming that it can be made to reach the
> affected coronary artery.  It has the advantage that it requires only
> one grafted attachment, while a segment of vein from a donor site
> requires two.  I had a sextuple bypass, and I believe they used the
> mammary artery on the most dangerous blockage.

--------------

If I understand the original posting correctly, the procedure was
standard coronary bypass surgery, using an internal mammary artery.
The outstanding advantage of these arteries (right and left) is that
they almost always last for a very long time, unlike vein grafts (from
the leg) which have a high rate of early and late thrombosis and
closure.  Arteries are naturally a better choice than veins to replace
the native coronary arteries, and several other donor arteries have been
tried in recent years:  the radial (wrist) artery has also proved very
successful.  In our hospital we regard use of leg veins as last-resort
stuff.

David Rollo



Fri, 28 May 1999 03:00:00 GMT
 INFO REQUEST: Artery blocked at 70% : operation vs other alternatives


Quote:
>My mother needed a bypass but was not a good candidate for one because of her
>fragile state.  They tried meds, but she continued to worsen.  She recently
>had surgery where they took the MAMMARY artery and did some kind of
>"rewiring" in order to get better {*filter*} flow into her heart and help her
>chest pain and make her feel better -- which she does!  it's not as good as a
>bypass, ....

   The good news is that from your description, your mother actually
HAD a bypass, and instead of using a section of sapenous vein, her
surgeon was able to use one of the internal mammary arteries.  When
these arteries can be used, the results are better (longer lasting)
than the results obtained with vein grafts.

   The bad news is that either the surgeon confused your mother, or
that he and she together confused you.  Communication is an important
part of being a surgeon or mother.

            Robert R. Fenichel, M.D.



Wed, 20 Oct 1999 03:00:00 GMT
 
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