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STENT implantation for STENOSIS of MID LAD in CTANGIOGRAPHY.

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I am 58 years old patientold, i went for CT angiography with my friend for the first time. After the test, the report says that there is mixed plaques with significant stenosis (80%) in the proximal - mid LAD. Distal LAD is normal, the circumflex artery is dominant artery and no significant stenosis seen, the PDA, PLV, D1, OM branches are normal. The left main coronary artery is normal. The calcium score is 123. The RCA is a normal calibre artery.
Now i wanted to know that in how much time should i undergo the stent implantation and which stent is better option for me, the metal stent or the scaffolding stent that gets dissolved, as in india the dissolvable stent is widely available. Also is it important to under go the stent implantation? I am taking 3 medicines atorvastatin calcium tablets (storvas 40), aspirin delayed release tablets (ecosprin- 150) and clopidogrel tablets (clopivas - 75).

Category: Cardiologist

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Category: Cardiologist
 29 Doctors Online

Hello
Thank you for posting your query at DoctorSpring.com
What are your symptoms and how severe are they?
What led to this test?
Absorbable bio scaffolds are available in india. However the feasibility ofntheir use in any particular case can only be decided by after having a look at the coronary angiography. It may be difficult in tortuous lesions or calcified arteries. However thry also have an advantage that no metal or polymer remains after 1 to 2 years. So you should undergo an angiography to define the exact lesion and vessel anatomy. You could tell your cardiologist that you wish absorb stent if it is feasible. Let the final decision be with the cardiologist as to whether it is possible to implant absorb or metallic stent.
Feel free to discuss further,
Regards
Dr Vivek Mahajan
DM Cardiology


Patient replied :

I went for the test for the first time as just a casual test, i was not having any problem before this test, now also i do not have any problem in breathing or any chest pain or i do not even feel tired at the end of the day. But, only after this test (CT Angiography) i came to know that there is a plaque in the Mid LAD. So as prescribed by doctor i started taking medicines as i mentioned above. I just wanted to know within how much time it is necessary to undergo the stening angiography.


Hello.
Ideally, as per guidelines you need not undergo any diagnostic test if you are asymptomatic.
Now that you have an abnormal screening test and you are not having any problem because of that blockage it is confusing.
You could either try medical therapy and get an angiography done only if you feel angina or shortness of breath on exertion or you could straightway go for an angiography and get the blockage treated if it is significant.
Angioplasty or bypass are for symptomatic relief. They do not extend life.
Since you do not have symptoms the value of angioplasty is not too great. You could try medical therapy and if symptomatic you could get angiography. If you are too scared about the blockage you could straightway go for angiography.
Regards, Dr Vivek Mahajan, DM Cardiology.


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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