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Angioplasty and Stenting in the Elderly

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Do you need information about coronary stenting in the very elderly (geriatric) population over 80 years of age? Read the comments below for discussions about increased complication rates and more. Share your story, ask questions, and get support in our heart patient community.

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Current Postings on This Page (152):

• Bob - Your mother's cardiologist is doing what's called a "staged procedure." Whether or not to do everything in one session depends greatly on the clinical situation of the patient, but it's not uncommon to split it up and may be the wisest choice. We cannot comment on such specifics. If you are uncomfortable with his decision, feel free to get a second opinion.
Angioplasty.Org Staff, Angioplasty.Org, November 6, 2013

• My mother, who is just had two stents put in the right side of her heart. He cardiologist want to put two more in the left side. I asked him why not do all at once and he said it would put less stress on my mother to spread out the procedures. Is this normal?
Bob in Sarasota, Sarasota, Florida, USA, November 4, 2013

• I am conducting a study in the area of " Diagnostic imaging techniques of coronary heart disease ". One aspect of the research that I am doing is to conduct a questionnaire among cardiac patients to observe their views on the techniques they went through for diagnostic imaging. The Questionnaire consists of the following four parts: general information, the procedure, the pre- and the post- procedure. The questionnaire will take approximately 15 minutes. English/Arabic: https://www.surveymonkey.com/s/CardiacImQ I appreciate your kind help and devoting the time to share your experience.
Mr. M, UMCG, USA, November 3, 2013

• I am a retired govt officer from Govt of Gujarat India Health Department. After several years study and experiments I have found that there is no need for angiography or angioplasty except some critical cases. It can be cured with the help of a specially formulated herb juice twice a day. If any one interested mail me on maanojmeuva@gmail.com. It is totally free of cost. Only for humanitarian purpose. Few life style changes and yoga-breathing exercise can feel u healthy all life.
maanojmeuva, Meuva's life care centre, Gujarat, India, November 2, 2013

• Pat in Montreal - Angioplasty procedures require the use of contrast dye, which impacts the kidneys. Your father's kidneys are not functioning well and so, the contrast may cause kidney failure. We cannot give medical advice but we would urge you to get a second opinion. Also ask whether the cardiologists think EECP therapy mght help.
Angioplasty.Org Staff, Angioplasty.Org, November 1, 2013

• Hello: Father is 84 Years Old. Very active, good shape. But under normal conditions which has been for 10 years his Kidneys function at 22%. He has heart problems all of his life. His arteries are blocked and they say they cannot perform angiogram due to Kidneys or even attempt angioplasty. Is there something else that is less invasive that can be done to assist. They say open heart surgery is not an option due to the fact it will leave him on dialysis. His arteries are blocked and they say they cannot attach new arteries because his circulation is poor. But he is very very active and is full of life. Is there something less invasive that can be done. Thank You.
Pat, Montreal, Quebec, Canada, October 25, 2013

• Pallavi - both heparin and faximab (abciximab) are anticoagulants and have the side-effect of bleeding. During angioplasty, these meds are used to keep the blood from clotting. Abciximab and heparin have been tested against another drug called bivalirudin. The results are similar in terms of the angioplasty, but the heparin/abciximab combination has shown to have more bleeding complications.
Angioplasty.Org Staff, Angioplasty.Org, October 23, 2013

• my father passed away last month after angioplasty was done. he had multiple internal bleeding, he had brain hemorrhage. doctors say it is because of blood thinning medicine. my father was given heparin and faximab. i don't understand who is responsible.
pallavi, Bangalore, India, October 21, 2013

• To all posters, please read our article on the XIMA trial, testing stents in octogenrians.
Angioplasty.Org Staff, Angioplasty.Org, October 20, 2013

• 87 yr old man, congestive heart failure, ischemic heart disease, irregular heart beat. Paget's disease, takes diuretics for fluid build up which has improved breathing,heart attack 25 years ago. Otherwise very active and intelligent. waiting for isotope scan in a couple of days, what's the best way forward in your opinion and prognosis please
worried, England, United Kingdom, October 19, 2013

• How safe is wrist angioplasty/possible stent in elderly? My father is 88. Had stent in one artery ~7 years ago. All went well. At that time it also showed ~40% blockage in two other arteries. No real symptoms since until recently. He walks about 30 minutes every day and goes up and down steps several times a day but now getting short winded with pressure in chest. Feeling very tired. Had tests suggesting additional blockage and kidney function at 48%. Otherwise he is healthy. Takes some blood pressure medicine. Isosorb and Ranexa not helping symptoms. He wants to get back to walking. Trying to understand the angioplasty risk. Thank you!
K. R., Latrobe, Pennsylvania, USA, October 19, 2013

• My Dad is 79 yrs old and has been told that his heart is only working at 25%. He is to have an angiogram done next week. He has had stents put in before. What are the chances of his heart not being able to handle the stress of the procedure?
LaNeda, Crescent City, California, USA, October 9, 2013

• good morning, Experts my father is 80 years old,in yesterdays angiography report there are two blockage founds so doctors suggest us for angioplasty i have confusion whether age is issue for angioplasty.
prem, ctpl, Nandurbar, Maharashtra State, India, October 3, 2013

• Hello. My grandfather is above 85 and recently he had a heart attack and was hospitalised were he had another heart attack with failed thrombolysis and developed A/V dissociation. Doctors put him on temporary pacemaker to which he responded well but doctors suggested due to old age they cannot replace it with a permanent one. They discharged him with some medicines like ATROVA 40,CLOPITAB,FRUSELAC. We have lost all hopes of him recovering can u kindly suggest anything. :-(
romana, Srinagar, India, September 25, 2013

• Angiogram showed 100% blockage in the LAD at the upper level 'T' position. Can a stent be placed at this area of LAD. The doctors said they have to review and get back to me.
Bobby, Toronto, Canada, September 23, 2013

• Myself 44 years male, had undergone PTCA in 2012 with 2 DES namely PROMUS ELEMENT, for Left main 70 % block & PDA. Is it safe & proven way of treatment for the left artery main blocks? Since earlier recommendations were bypass surgery , these Stenting treatments are well proven or does it require any further investigation?? pls. advice
PK, Karnataka, India, September 17, 2013

• English Rose - We are strong advocates of IVUS use to correctly size and position stents. Back in the 90's when stents were first being used, Dr. Antonio Columbo of Milan used IVUS to show the most stents were being undersized and under-inflated. A poorly fitted stent can give rise to blood clots (stent thrombosis) which usually manifests itself as a heart attack.
Angioplasty.Org Staff, Angioplasty.Org, September 16, 2013

• My 89 year old Father had his 1st heart attack January 2012, he was given 2 stents, but continued to have chest pain, he had 2 more stents in Feb 2012 followed by 3 more in March 2012. he had several episodes of bad pain but was reasonably stable until June 2013. It was discovered during another angiogram that stent was undersized. Am EBU4 guiding catheter was used. Two wires were used, one for the LAD and one for the diagonal branch. The diagonal was dilated with a 2 mm balloon. Intravascular ultrasound was then performed this showed that the diagonal was actually a 3 mm vessel and that the stent was under sized. There was mild restenosis inside the stent only. The diagonal was then dilated further with a 3 mm non-compliant balloon. Then the LAD stents with IVUS were examined. These were well opposed with no real in-stent restenosis. The proximal LAD before the diagonal was actually a 4.5 mm vessel, although the stent here was only around 3 mm. Given the discovery of undersized stents, in your opinion could this have contributed for him having 4 more heart attacks after the original in Jan 2012.
English Rose, London, United Kingdom, September 11, 2013

• AAN in Pune - when you say "brain angioplasty," do you mean "carotid artery stenting?" We'll assume you do. Atherosclerosis, the disease your father has, can appear in several different arterial systems, the coronaries (heart), the legs, the carotids (neck or "brain"), etc. Sometimes the blockages caused by atherosclerosis can be managed by medications. If not, then re-opening the blockages may be indicated. This re-opening (called revascularization) can be done through open surgery or through catheter-based angioplasty and stenting. We'd suggest getting two opinions, one from the interventional cardiologist or radiologist who would do the angioplasty procedure; and one from a vascular surgeon, who would do the open surgical procedure.
Angioplasty.Org Staff, Angioplasty.Org, August 29, 2013

• Hi, My father is 81, He has long cardiac history in 1984 he got first heart attack. Then in 2002 next one this time he under gone through Bypass surgery. In 2012 again an heart trouble treated by angioplasty. His heart is 30% working as per doctor. In the mean while diabetes and high blood pressure was also detected. In July 2013 he got paralysis attack/stroke. Dr suggested Angioplasty for brain. But told that there is risk related to that. My father is not willing to go for angioplasty. but he got another paralysis attack on 15th Aug 2013. Now again doctor is suggesting Angiography and then if required angioplasty. Now we're in confusion what to do. Can you please help me in identifying the risk involved in brain angioplasty based history I provided. Which will help me to take decision on this. Thanks.
AAN, Pune, India, August 20, 2013

• Dear Angiogram in Bangalore - We cannot and do not give medical advice in place of a physician. Given the data you have sent, it seems as if trying medical therapy is a good start. Recommendations in the U.S. are that angioplasty is done in emergency situations, such as a heart attack, when an emergency looks likely, or to relieve symptoms when medicine doesn't work completely. We would also strongly urge your father, with your support, to do whatever is possible to lower his risk factors: stop smoking, if he does, stay active physicially and exercise, watch diet, etc. His cardiologist can be of assistance here, since he/she has a more complete clinical picture of you father.
Angioplasty.Org Staff, Angioplasty.Org, August 15, 2013

• My father is 67 yrs, recently we did the angiography and the reports are like below. Mid 30% stenosis, distal RCA 30% stenosis, PDA has proximal 30% stenosis, Mid Distal RCA has 90% stenosis, PLB has ostial 50% and mid 70% stenosis. Doctor advised to take medicine. pls let me know whether we have to go for angioplasty.
Angiogram, Bangalore, India, August 12, 2013

• Angioplasty in Kolkata - You've posted to a topic about elderly patients, which 45 years is not. You should look to your cardiologist for specific medical advice and do what you can to lower your modifiable risk factors.

And Raj from Hyderabad -- Your report shows multiple vessel involvement with a lot of calcification. We don't give medical advice, but would not be surprised if you aunt's cardiologist has recommended bypass surgery, assuming, of course, that any intervention at all is called for. Much would depend on the condition of her heart, if there is viable myocardium (muscle) in areas supplied by these narrowed arteries.
Angioplasty.Org Staff, Angioplasty.Org, August 11, 2013

• My angioplasty with stent has been done one year ago but already start further problem and 2 CVA has been done as doctors report, my age 45years please give me suggestion.
Angioplasty, Kolkata, West Bengal, India, August 1, 2013

• Hi,My Aunt had a minor heart attack recently. She is 66 years old, has diabetes and also has had other minor health issues. The angiogram said that she has:Ostial left main has 40-60% stenosis Proximal, Mid and Distal LAD are calcified Ostial LAD has 90% stenosis Mid LAD has 70-80% stenosis Entire LCX heavily calcified Distal LCX has 50% stenosis Entire RCA heavily calcified100% proximal RCA blockage Can you please advise on what would be the right treatment for her? I understand that you cannot give a complete diagnosis based on just this information, but I am looking for some guidance on anything that you may see as obvious for such a patient. thank you. I really appreciate you helping all of us out.
Raj, Hyderabad, India, July 29, 2013

• Arpith - Not possible to say without more specific information. Stenting may be possible, even though there is disease in all three arteries, but that depends on several factors. You should have his cardiologist discuss with you and your father the pros and cons of stenting vs. surgery (a.k.a. CABG or Coronary Artery Bypass Grafting).
Angioplasty.Org Staff, Angioplasty.Org, July 28, 2013

• hi, my father is 77yrs and after going thru angiogram , we were told he had blocks in all the three arteries,, I'm the rest would be told tomorrow and as to what is to be done,,I'm from southern part of India... the nurse said the possibility was to go thru the open heart surgery.. or stent or angio plasty,, etc please tell us how to go further
Arpith, Bangalore, India, July 22, 2013

• To poster from Noida - You can help your father and you should ask your father's cardiologist: (1) Why did he have 3 separate procedures in this short period? They may have been "staged" - where it is felt to be safer not to do everything all at once. Or, possibly one stent closed up quickly and needed to be re-opened, probably with another stent. It would be good for you to know this. (2) What can your father do to lower the risk of his coronary artery disease progressing and getting worse?
Angioplasty.Org Staff, Angioplasty.Org, July 21, 2013

• Hi - My father 77 years old have gone thru angioplasty three times in seven month. Any advice in this regard?
Angioplasty and Stenting in the Elderly, NOIDA Uttarpradesh, INDIA, July 20, 2013

• JW in Los Altos - Was this angioplasty done in the setting of a heart attack (which is caused by a sudden total blockage of a coronary artery)? Or was the 100% occlusion historical. Your mother's medical history would be important, because congestive heart failure (CHF) is a condition that usually develops over time. What is odd is that her LVEF was normal immediately post-angioplasty and suddenly two weeks later she is retaining fluid. We cannot and do not give out medical advice, but hers is a complex situation and we would recommend that you talk directly with her cardiologist for more specific answers to these questions.
Angioplasty.Org Staff, Angioplasty.Org, July 18, 2013

• My mom (78 yrs) had a angioplasty procedure for 100% blockage @LAD. According to her cardiologist, she didn't sustain permanent damage to her heart; (65% LVEF) reading after procedure. Two weeks after angioplasty procedure, she suffered CHF (Congestive Heart Failure; real short of breath) due to fluids in her lung & heart. It has been 2 weeks since she had CHF. During her Cardiac Rehab exercise class, her blood pressure drop (125/67 to 79/56) repeatedly last 3 classes (3 days/wk). She did feel a bit dizzy/light headed for first 2 classes so she had to stop her exercise, but she felt OK for her last class w/ BP reading 89/59.She’s on following medication: Lasix; 40mg 1x/day, Spironolactone 12.5mg; 1/day, Losartan 50 mg; 2/day, Carvedilol 25 mg; 2/day, Aspirin 325mg; 1/day, Clopidogrel 75 mg; 1/day. What’s causing her low BP and dizziness?
jw, Los Altos, California, USA, July 18, 2013

• Deb in India - If you read our article on the XIMA study, you'll see that angioplasty can be quite beneficial for elderly patients. The real question is whether the specific angioplasty procedure being contemplated is beneficial, period, for any age patient. And that is a complex question. Cardiology organizations have published appropriateness guidelines. They include questions about whether the patient is "symptomatic," i.e. having angina pain. And whether or not the blockage is "significant", i.e. impeding blood flow. Just saying there is a 60% or 70% blockage does not necessarily mean the blockage is significant. But if there is additional evidence from a functional test, like a stress test, or an FFR measurement made during the angiogram, then evidence is higher. Also where the blockage is, in which artery, etc. The big question in interventional cardiology is when revascularization (angioplasty or surgery) will be of benefit, or whether medical management is sufficient. Perhaps a chat with your father's cardiologist would be helpful to you in explaining why he/she feels the procedure will be beneficial.
Angioplasty.Org Staff, Angioplasty.Org, July 9, 2013

• Hi. My Father is 75, and is healthy for his age. He has diabetes which is under control and also has high blood pressure. Couple of weeks back he had a routine check which is when he was advised to go in for angiography. The report confirms that he has 5 blockages ranging from 60%, up to 90%. The doctor has advised stents for at least 2 blockages. I am skeptical due to his age, and not sure if I should go ahead with the same, as otherwise he is keeping himself hale and hearty. Best, Deb
Deb, India, July 9, 2013

• Margaret -- 92 and playing golf! That's great. You mention a "routine stress test" and we're just wondering what you mean by routine? Stress tests are usually not indicated unless there is a history of heart disease, or the patient is symptomatic. This is something we don't know about (and this is why no one on the internet, including us, can give you medical advice). Specifically what type of stress test did your father have? (You can see the various types in our Imaging and Diagnosis Section.)

Medication can't really reduce the blockage (if there is a narrowing that is significant) but it can relieve symptoms. Angioplasty/stenting is the next step and this procedure physically opens the blockage, but again it's only indicated to relieve symptoms. It's not proven to prolong life. Of course, if the angina or other symptoms are significant, relief can be important. If the stress test shows a "perfusion deficit", a reduced flow of oxygenated blood to the heart muscle, then the next step usually is an invasive angiogram to see if there is actually a blockage (more than a third of angiograms show no blockage -- which means that a third of stress tests are "false positives"). There is also the option of a CT Angiogram, which is non-invasive, fast, but not available (or reimbursed) everywhere. There are risks with any intervention. If an angiogram/angioplasty is recommended, ask your cardiologist about using the transradial approach, shown to have less bleeding complications than the femoral (groin) approach, especially in elderly patients.
Angioplasty.Org Staff, Angioplasty.Org, June 1, 2013

• My 92-year old father has been told he has a heart blockage but we don't know details of where or how many yet. The second half of his stress test is next week. The blockage(s) was found in a routine stress test although recently he noticed some discomfort in his throat when walking and playing golf, and his cardiologist says it is caused by the blockage. He has diabetes controlled with low dosage medication. Otherwise, he is healthy and plays golf once a week. If medication can not take care of the blockage(s), what are appropriate treatments available for someone his age and what are risks of the various treatments.
Margaret, Orange City, Florida, USA, May 28, 2013

• When we say "elderly", we mean "elderly", as in 104 years-old! Check out this article about the oldest patient successfully treated with a stent...and it was done via the wrist approach!
Angioplasty.Org Staff, Angioplasty.Org, May 25, 2013

• Sheppie -- We're sorry we were not able to respond to your post as quickly as you requested. We are not an "ask-your-doctor" service, but we were wondering if your friend has been offered a AAA stent graft which is like an angioplasty and is not an open surgical procedure that requires general anesthesia?
Angioplasty.Org Staff, Angioplasty.Org, May 12, 2013

• 86 year old man needing an angio and to fix a aorta aneurysm that has ballooned. He also has kidneys that are functionality 30%. The surgeon puts him at 10% risk for major complications. This man is a young 86 year old. Lives w his wife in their home. Drives and is a vibrant member of society. We r nervous for him and of the complications. He must give an answer today.
Sheppie, Manitoba, Canada, May 7, 2013

• Worried Wife -- First of all, your husband should discuss these issues with his cardiologist or with the cardiac surgeon who did the bypass. If he has had 3 bypass operations, it's probable that they may not have been able to do another and decided to stent the closed arteries instead. This is not uncommon: President Bill Clinton has just such a procedure a few years ago.
Angioplasty.Org Staff, Angioplasty.Org, May 6, 2013

• My husband is 73 & has had 3 open heart surgeries. Just 2 weeks ago they put in 4 stents & he is still having trouble breathing & pain in the chest. Should he have had 4th surgery instead of stents?
worried wife, Riverview, Florida, USA, May 6, 2013

• Dee in Colorado -- Whether or not stenting the other arteries would be of benefit depends on which arteries they are and what part of the heart are they supplying. If the part of the heart muscle being supplied is already damaged due to the heart attack, then opening up the blood flow probably won't have any appreciable benefit. However, if the heart muscle in these areas is still viable, then there might be a benefit. But it sounds as if his cardiologist has already weighed in on this. Of course, we always recommend getting second opinions when patients or relatives are not positive, even if only to be assured that the course of treatment (or not in this case) is correct. There is also a risk with any medical procedure, but octogenarians have been successfully treated with angioplasty. See our post about the XIMA study.

And Nola in Germantown -- you have a difficult decision to make. One question is with CHF, will an angioplasty have benefit? If her heart muscle is damaged, will opening up an artery make a difference in her quality of life? But this is not an easy decision to make.
Angioplasty.Org Staff, Angioplasty.Org, April 14, 2013

• 92 yr old mother had aortic valve (porcine) replacement in Nov. 2000. In Sept. 2012, she underwent her 9th angioplasty with stent placement. She was never the same after this procedure and was diagnosed with CHF. She was in rehab for a month and is now in assisted living and cannot do without oxygen. It is obvious that she is weak and declining and she is often confused and can't remember things. The assisted living director has suggested hospice. However, due to jaw pain and the amount of nitroglycerin she is taking for severe chest pain, we took her back to her cardiologist who thinks she has another blockage. He wants to do another angioplasty and put in a stent if needed, but he also said he thinks hospice would be another set of eyes on her condition. We think she is far too weak for another angioplasty and she is still not recovered from the last angioplasty 7 months ago. Should we simply opt for hospice and try to let her live out her days comfortably or do we risk the angioplasty?
Nola, Germantown, Tennessee, USA, April 11, 2013

• My 88 yr old dad was experiencing chest discomfort & shortness of breath in Feb. After a couple of days, consulted a doctor; blood test enzyme levels revealed he had suffered a heart attack. Before this he's had no health issues. Two weeks after heart attack, heart cath revealed 100% blockage in one artery and "extensive" blockage in two others. We were told angioplasty isn't an option for 100% blockage. Cardiologist recommended, due to his age, they do nothing. They got him in touch with hospice and sent him home. Could there be any benefit in stenting the other two blockages?
Dee, Franktown, Colorado, USA, April 11, 2013

• Maggie May - We can't comment on the specific risks of surgical mitral valve repair, but would point you to a news article in the KYPost about some concerns over robotic surgery. We'd also mention that there is a new interventional mitral valve repair procedure, called the MitraClip, for those unable to have sugery, although it's still awaiting an approval decision by the FDA and is not yet available in the U.S. You can read more about the MitraClip here.

And Silviya in India and Victoria in England -- Not sure what your father-in-law's or sister's clinical status is, but if neither surgery or stenting is an option, then definitely medical therapy and possibly other adjunctive therapies such as EECP might be an option. Victoria, while your sister may not be able to withstand surgery, have you discussed the less invasive angioplasty procedure with her cardiologist? General anesthesia is not used during angioplasty.
Angioplasty.Org Staff, Angioplasty.Org, April 10, 2013

• hi, my father in-law is heart patient by pass surgery heart surgery can not be done as surgical interference is not possible more over no angioplasty or no angiography. Please suggest me any alternative or any therapy.
silviya, travel industry, Patna, India, March 18, 2013

• I am a 71 yr old female. I have two leaking valves. My Mitral is leaking at Mild to Moderate. And I have another one at severe. They are telling me that the one that is leaking severe is not dangerous at all. But that I need to get my mitral repaired. And they want to do a robotic surgery. I did pass my chemical stress test. How dangerous would this be? Other wise, I am a pretty healthy person
Maggie May, Retired, Hebron, Kentucky, USA, March 18, 2013

• My sister had a heart attack and they could not unblock her arteries , her lungs are not good so she cannot have the Bypass operation so is there any other way they can unblock her arteries.
Victoria, Family, Birmingham, England, March 18, 2013

• Sheikh A in Pakistan -- We can't give medical advice, but we do urge you to talk with your grandfather's doctor(s) so that you are clear what they are saying is wrong and how they plan to treat it. Is it a blocked coronary artery? Or does he have a valve problem? Or something else? Ask if there are any less invasive ways of treating him, using angioplasty, for example. Open heart surgery (bypass is also open heart) is a major operation, especially in the elderly. In any case, find out everything you can (sometimes difficult because doctors have such over-filled schedules). The more you know, the more you can help your grandfather in his recovery.
Angioplasty.Org Staff, Angioplasty.Org, February 16, 2013

• My grandfather is a patient now, he was all right but one day at Friday at 3:00 clock so he ate nehari that day so the next day he was hospitalized and so we took him to national hospital in Faisalabad,so after 2-6 days the he came back to home and he was not right now doctors are saying him for a surgery and my cousin's father is also a doctor he is saying for a bypass or a open heart surgery and tell me what to do????
Sheikh A., Faisalabad, Pakistan, February 16, 2013

• Okierebel -- This topic is for elderly patients...and you're a youthful 62!. As you have written, you have highly calcified arteries. There is a tool that interventionalists use, called the Rotablator, which is specifically designed to "sand down" calcium in the artery. So if you have a specific blockage, this might be an option. It is a specialized device and not all interventional cardiologists are experienced in its use. As for medications to reduce your plaque, some statins have been shown to slightly reduce plaque, but their main use is for prevention of progression and reduction of risk factors. Obviously, and we assume you've discussed this, one big risk factor you have is your weight -- your body mass index is very high (you can measure it on the Surgeon General's web site) and classified as obese. If there is anything you can do to significantly bring your weight down, that would be a major help, along with smoking cessation (if you do). But we realize that this is something very difficult to do alone, and we recommend that you discuss this with your GP and get support for this effort. Good luck!
Angioplasty.Org Staff, Angioplasty.Org, January 19, 2013

• I am a 62 yr old male, height 6' weight 300 lbs, my calcium scans show heavy levels of plaque. 1900 2yrs ago, 2300 last year. An arteriogram showed my plaque has stretched my arteries too much for angioplasty, stents, and can not be nibbled out, and are too thin for bypass. My cardiologist said he had no surgical options. Are there any statins or other meds to reduce my plaque rather than letting it run away? Hopeful in Oklahoma.
Okierebel, medically retired., Oklahoma City, Oklahoma, USA, December 29, 2012

• For all posters interesting in the latest information about stenting in the elderly, read our report on the late-breaking XIMA trial, testing stents in octogenarians. Also check out the Editor's Blog for some rocking 80-year-olds.

Specific responses to posters below from Monterey and India: Monterey -- if your dad has very diffuse multivessel and left-main disease, bypass surgery may be the preferred option. Was this the opinion of the interventional cardiologists? One issue has been, as an example, that a patient with three-vessel disease may only have two ischemia causing lesions when measured by fractional flow reserve duing the angiogram. In this case, what might be a case for surgery (three arteries) could conceivably be done just as well with angioplasty stenting only two arteries. Read more about Fractional Flow Reserve (FFR) in our Intravascular Guidance Center.

And to Cyret, India -- the above information may be useful as well, but we cannot give medical advice in place of a qualified medical doctor. You might want a second opinion. Certainly age is not a restriction for these procedures, but your father's health status may be.
Angioplasty.Org Staff, Angioplasty.Org, October 30, 2012

• My father is 70 years old. he has been hospitalised due to serious vomiting and dysentery. The Doctor-in-charge told that the ECG showed the symptoms of a mild heart-attack. he was advised for angiogram. If necessary angioplasty may be done. After angio doctor has refused to do angioplasty or surgery do to his age factor and 25 years of diabetes and some long standing kidney problem 3 years (creatine level rise). After angio he has 3 major blocks in artery in heart. Please inform can i go with as per doctor advice or we can go for a surgery or angioplasty
After 70's can we go head for surgery or angioplasty for patient with diabetes, Cyret, India, October 25, 2012

• My father is a seemingly healthy 71 year old man who exercises daily and eats fish and rice with a no-dressing salad when we go out to eat. We were expecting the angiogram to tell us that he needed a stint [stent] or an angioplasty, but the doctors want him to get a quadruple bypass. Could you tell me what the percentage is for success at his age?
71 year old male quadruple bypass, Monterey, California, USA, October 10, 2012

• The performance of her valve replacement can be measured somewhat by an echocardiogram and also during the cath to see if the valve is still performing okay. If it is failing, there may be a new alternative. Last year, the FDA approved a new type of aortic valve that can be inserted percutaneously, like a stent, via the femoral artery: the Sapien valve. This device is approved only for very specific types of patients who are not candidates for open heart surgery. Another device, called the CoreValve is also approved in Europe, but not yet in the U.S.
Angioplasty.Org Staff, Angioplasty.Org, September 22, 2012

• In Aug. 2000, my mother-in-law had aortic valve replacement with a tissue valve. Since that time, she has had to have several heart caths with stents used to open blockages. She is now 92 yrs old and the tissue valve is 12 years old. She has another blockage and is scheduled for another cath. Is this advisable? It is my understanding that tissue valves begin to deteriorate after 10 years. Her heart is weak and she takes 13 medication a day some of which are Plavix, Zetia, Benicar, Synthroid, Norvasc. She also has diabetes. We are concerned that she is undergoing a procedure that may help her short term, but the valve is wearing out. What should we expect or what questions should we address to her cardiologist.
concerned loved one, Memphis, Tennessee, USA, September 18, 2012

• Diane in New Jersey -- we think you are referring to an AAA stent graft. This is a stent inserted through the femoral artery and placed in the aorta, inside of the aneurysm. You can read more about these and watch a video about the first one of these procedures done in our article, "Stent Grafts for Minimally Invasive Aortic Aneurysm Repair." You might want to contact the Society for Vascular Surgery (SVS) or The Society for Cardiovascular Angiography and Interventions (SCAI) for referrals...or pop into the Veith Symposium in New York this November where you'll find an auditorium-full of experienced physicians who do this procedure (Dr. Veith participated in the first AAA procedure done in the U.S., as you see on the video).
Angioplasty.Org Staff, Angioplasty.Org, August 14, 2012

• My dad is 85 and has 2 descending aneurysms. (5.7 cm). considering having stents put in. looks to be in great shape, underlying issue, emphysema, high blood pressure, kidney blockage. Dr. says he can do it, another Dr. says complicated procedure. how do we assess the risk. where can i find a list of Dr.'s who perform this procedure. Thank You!
Diane, New Jersey, USA, August 6, 2012

• A 90 year old man (quite fit otherwise) has ischemia of the area served by the left anterior descending coronary artery which served the apex and the left anterior wall. Options include pravachol for cholesterol of 225, HDL 72 and LDL 137, nightly long acting nitrate and addition of Plavix to low dose aspirin or cath and possible stenting.
Old athlete, Kingsport, Tennessee, USA, June 1, 2012

• Chandra from Hyderabad -- This topic is about angioplasty in the elderly. 41 years old is relatively young. We do not give medical advice and certainly couldn't comment on such detailed data as you have provided. Yours is a complex situation and we would urge you to consult both a cardiac surgeon and interventional cardiologist. Ideally they would consult with each other as well and agree on the best course forward.
Angioplasty.Org Staff, Angioplasty.Org, February 24, 2012

• I'm 41yr CABG patient and got discomfort in chest and admitted in hospital and got angiogram as follows pls advice me LMCA:normal,Lad:TypeIII vessel, ostial total occlusion,RAMUS:Proximal 80% concentric lesion followed by another 70%lesion,LCX:Non dominant system proximal 80%lesion. OMs:OMI intermediate sized vessel, ostial 95%lesion.OM2 and OM3:normal,RCA:dominant system, proximal total occlusion,LVANGIO:not done good LV function by 2decho.bypass infmn grafts to #LIMA->LAD,SVG->RCA/DI.CATH ADVICE revascularization after GPIIb/IIIa,Cath diagnosis:#CAD:TVD.LIMA->LAD:Patient,SVG->D1:PATIENT,SVG->RCA:sub total occlusion
Chandra S., Hyderabad, India, February 21, 2012

• SWatson in North Carolina -- Sorry for your father's situation. It's not possible to estimate a figure like that -- but you should discuss this with his cardiologist. When you say his heart is blocked 100%, do you mean one of his arteries? It is completely possible to function with a blocked artery if there is supply from others (the heart gets its blood from several arteries). Obviously he should take the prescribed meds and do whatever he can to reduce his risk factors (stop smoking, etc.). There are specialists who take on difficult cases like total blockages. Not sure if he would be a candidate though.
Angioplasty.Org Staff, Angioplasty.Org, February 15, 2012

• My father is 65 and had 2 open heart surgeries and several stints [stents] and balloon surgeries, He was just told today that his heart is completely blocked 100% they could not do any stints on him. They gave him medicine to take, I want to know what will happen if the medicine does not work? How long can he live with his heart like this? The doctors told us 2 years ago he was in heart failure and there was not much left that they could do. I am really looking for an answer to how much more time we have with him. My grandfather told me it was just a matter of hours or a few days that he won't live too much longer, so I want to know a right and around time limit? Thank You!!
SWatson, North Carolina, USA, February 13, 2012

• Electricman in Florida -- coronary artery disease is a progressive chronic condition. While it's very important to reduce any risk factors (exercise, diet, stopping smoking, and taking prescribed meds) it can continue to advance, although much more slowly. Also, stents do get reblocked sometimes, called restenosis. Earlier bare metal stents had migher restenosis rates; current drug-eluting stents restenose in less than 1 out of 10 times. Bypass grafts can also reblock.
Angioplasty.Org Staff, Angioplasty.Org, February 1, 2012

• how do i prevent additional stents, I started with 2 stents to start and 5 years later i needed 3 more. thanks
electricman, citizen, West Palm Beach, Florida, USA, February 1, 2012

• D.Burhans in Pennsylvania -- Angioplasty is safe and effective in an elderly population (Prince Phillip of England just had a heart stent and he's the same age as your mother). However, complications do occur more frequently in older patients mainly because their arteries tend to be stiffer, more prone to injury, etc. Angioplasty was initially conceived of by Charles Dotter in the 60s specifically to treat peripheral (leg) patients like your mother and increase circulation. But discuss these concerns with the cardiologist or vascular surgeon who may be treating her -- ask what the possible complications may be and how they would be dealt with. And we need to state that this site should not be used as a substitute for medical advice from a healthcare professional or your doctor. Let us know the outcome, if you would. Thanks.
Angioplasty.Org Staff, Angioplasty.Org, January 4, 2012

• My mother is 90 is being treated for the last 8 weeks for a wound in back of her calf. The wound center has called in a cardiologist who is talking about putting stents in her legs to increase circulation. She has chronic venous stasis with right calf ulceration and is on Coumadin 5mg and amiloride 50 mg. Her calfs are now as large as her thighs. She is told to put her leg up to her heart level but the pain is too great in her leg for her to do so. Are venous stents safe for a 90 year old on Coumadin. Is this a usual procedure?
D.Burhans, Downingtown, Pennsylvania, USA, January 4, 2012

• Judson in England -- there are no medical concerns regarding the MRI and stents since she doesn't yet have a stent put in. MRIs can be scary, especially the "closed" MRI units -- many people can't tolerate the enclosed space. See if you can find a facility with "open" MRI units. Angioplasty can be safely done on elderly people. Read our topic on "Angioplasty in the Elderly".
Angioplasty.Org Staff, Angioplasty.Org, December 9, 2011

• my mum had a triple by pass 10 years ago and is now 80 she has diabetes and a wedge fracture of the spine and her cardiologist said her arteries are blocking and she needs a stent put in and an MRI she is too scared to have the MRI and my dad is panicking she is 82 and dad 86 how can I help her?
judson c, student, Chislehurst, Kent, England, December 3, 2011

• Dear Help in Florida -- It's not possible for us (or perhaps anyone) to say how long you can wait before you "need" to get a stent put in. One question is if you are stable -- from your description, you are only suffering angina on exertion. Have you discussed with the cardiologist your concerns and also your need for having the bronchoscopy?? Many studies have shown that in stable patients, there is not a need for an emergency angioplasty -- but again, your cardiologist has all the information and may have a very valid reason for the urgency.
Angioplasty.Org Staff, Angioplasty.Org, November 12, 2011

• Had angiogram performed and was told there is a 75% blocked artery and the doctor is setting me up for angioplasty 1 week later,i had no time to think whether do it right away or delay it cause I also need to have done a bronchoscopy,and maybe should be done first. If I have angioplasty done first a bare-metal stent will be used because I would have to stop taking Plavix to have the bronchoscopy done , if after bronchoscopy a drug-eluting stent will be used, which I think is better. Do I need to rush and have the angioplasty done right away,symptoms are chest pressure only when walking fast or do I have time to do it latter. There is also the idea of a second opinion since this is being set up so fast. How much time do I have.
Help, drug-eluting or metal, how much time now or wait, Oviedo, Florida, USA, November 11, 2011

• EH in Florida -- EECP is definitely a therapy used in patients with coronary artery disease. There have been several trials that have shown varying degrees of success. We have a Forum Topic devoted to EECP and you can read some patient stories there. You are correct that EECP is available in a number of highly-regarded heart centers. It's not a question so much of safety, because it is non-invasive, but of effectiveness. It certainly is not an equivalent to angioplasty or bypass surgery, but it may provide relief of symptoms in some patients, increased ability to exercise, etc. If you "search" Angioplasty.Org for EECP (type it into the search box at the top of this page) you will find over 30 articles on the subject. By all means, let The Forum know if you try it and how it works for you.
Angioplasty.Org Staff, Angioplasty.Org, October 31, 2011

I wrote earlier about Angioplasty in the elderly -- EH in Florida -- I have found on the internet a VERY accepted alternative which gives the same results as Angioplasty without the risks --- EECP ( enhanced external counterpulsation) FDA and Medicare approved. It is in wide use by the likes of Mayo Clinic -- John Hopkins -- Cleveland Clinic - and some hundred or more locations in the world. It is a puzzle why this is so unknown among cardiologists.!! I would advise your readers to Google up some of the lengthy explanations of its value. May I please have your opinion of its safety Thank You
EH in Florida, New Smyrna, Florida, USA, October 30, 2011

• Bharati -- we are most sorry for your loss. It's impossible to tell long-distance what might have happened. The question would be what caused the hemodynamic collapse during the procedure. Was there a dissected artery or some other complication? It seems that the following cascade of events started with that. By the way, you posted to a topic about "Angioplasty in the Elderly" but you say your huband was 44 years old?
Angioplasty.Org Staff, Angioplasty.Org, October 30, 2011

• My husband 44yrs who had no Blood pressure no diabetes, had 1 block and the doctor advised to do angioplasty. After the angioplasty within 2 hours his blood pressure suddenly decreased to 50/60. Doctors gave 72 hrs for his recovery. After some 12 hours they put him under ventilator to give rest to the heart. But he started getting fever 105/106 temp. He started getting spikes and this carried on for a week. After that he had acute renal failure. Doctors started with dialysis. He suffered for 1 month and exactly after 1 month he died. Doctors told that he died of septicemia with pneumonia. It is still a big question mark for me how all this happened. In the report they have mentioned during angioplasty the hemodynamic collapse. Could you provide exactly how can this happen?
bharati, Goa, India, October 24, 2011

• My mother in law is 70 she is having open heart surgery, she has had arthritis from a child. But suffered pneumonia and other breathing problems over the years, on steroids and taking the flu vaccine.
anjo, United Kingdom, October 22, 2011

• Sibarama -- We cannot give medical advice in place of a doctor, but the decision to go forward with an angioplasty is a complex one. Angiograms by themselves are pretty safe as medical procedures go. There are, of course, potential complications with any procedure -- with an angiogram, the primary one (still very low in percentage) is an access site complication: bleeding, hematoma, etc. at the access site in the groin (femoral) artery where the catheter is usully placed. In India, the radial or wrist approach is also used quite a bit which lowers these types of complications. Often, when a diagnostic angiogram is done, and a significant blockage is found, the cardiologist performs angioplasty and places a stent in the same session, called an "ad hoc angioplasty". This only adds 15-20 minutes to the procedure. Of course, this also requires you to be taking antiplatelet medicines for a sigificant amount of time. We suggest discussing these options with your cardiologist before the procedure so you are fully informed of the risks and benefits -- and what the result might be of not doing an angioplasty and treating any disease with medication instead -- or at least to defer the procedure to see if medications are helpful.
Angioplasty.Org Staff, Angioplasty.Org, October 22, 2011

• I am 74 yrs old having no anginal pain or arrhythmia. My LDL levels are 223mg/dL. After a TMT my cardiologist suggested for angiogram as the report says positive for provocable ischaemia and if necessary for angioplasty by placing stent. I want to have your suggestion is it safe to have an angiogram done. I am cycling regularly and doing 20-30 min. walks regularly for many years. My BP is 140/80 after taking medications which was 180/100 some days back. I am not feeling up to an angioplasty instead i want to have just medicines and lead a healthy life style for my age. Secondly will it be safe for doing this procedures at 74yr age. I got a bit exerted at the Peak Exercise Level 3 after which TMT was stopped. Kindly provide some guidance.
Sibarama, Orissa, India, October 22, 2011

• Fri Sept 30 - My sister-in-law has a myocardial infarction Sun Oct 2: Medication: Heparin until results were satisfactory and then back on Warfarin tablets. Thurs Oct 6: She was being treated with Heparin, Plavix and Aspirin. She has developed complications from this treatment where she has bleeding, suspected to be from the stomach. Her glucose control is remarkable for a diabetic patient. The low blood pressure she had has resulted in kidney damage, but has improved by flushing. She was taken off the blood thinners Sat Oct 8:can't operate yet because of internal bleeding Mon Oct 10: drinks pass thru her; weight loss; sits up but no walking. Still on drip. Still off the warfarin. Thurs Oct 13: angiogram determined 1 blocked artery and one half blocked artery. The doctor says if we don't operate immediately she WILL have another heart attack. Planned: Percutaneous Coronary Intervention Tues Oct18: Nurse said prescription was filled for a shorter acting blood thinner; the warfarin should've been stopped, but the doctor did not give the order;she was getting BOTH;it takes 3-5 days to exit system. Tues Oct25: Date scheduled for "emergency" operation. Is this normal? What can we do?
WEL, Clermont, Florida, USA, October 19, 2011

• E.H. in Florida -- First of all, we do not and cannot give medical advice as a doctor can, and we certainly are in no position to second-guess your cardiologist. But here's some standard info. You report that you had a stress treadmill test. Was this a nuclear test where you were given a radioactive isotope "tracer"? The nuclear test, although it can have a high percentage of false positives, would show if there is ischemia (restricted blood/oxygen flow to the heart muscle) using colors. You report that he saw "a shadow" -- we're not sure what that means. Also sometimes a CT angiogram is done instead of a nuclear stress test. But usually one of these non-invasive tests is performed before a patient goes to the cath lab. If there is no ischemia or blockage shown on these non-invasive tests, then, unless the patient is experiencing symptoms or there is some over-riding problem, the diagnosis is usually that there is no significant coronary artery disease.

Even if these tests show ischemia, the condition may be able to be treated with medicines only, especially in a stable patient -- although you report having no angina at all. Even if the patient is sent on to the cath lab, the interventional cardiologist first performs a catheterization, a.k.a. angiogram, which is a diagnostic test only. This may reveal if there are critical blockages which can be opened and a stent placed. Although angioplasty is certainly performed on octogenarians quite successfully, it is an invasive procedure and, if a stent is placed, the patient must take aspirin and Plavix for a year minimum. This is expensive and Plavix can have side-effects. Given your age and your reportedly good health, we would urge you to discuss this further with your cardiologist and ask him/her what will happen if you don't get an angioplasty, or if there are other non-risky tests that can be done to eliminate a diagnosis of CAD (coronary artery disease). CT Angiograms have been found to be very accurate in ruling out CAD. Perhaps he is putting your stress test results together with other clinical data, like your need for a pacemaker and your AF, and he feels that angioplasty may provide a benefit. Again, we are in no position to advise you one way or the other and these are decisions best made between you and your cardiologist. For more info, check out the links in this reply and also read "You and Your Physician" in our Patient Center. Good luck and please let The Forum know how you fare and what you decide.
Angioplasty.Org Staff, Angioplasty.Org, October 12, 2011

• I just had a stress treadmill test -- i am 86 - I have AF and a pacemaker just installed -- the interventional Cardiologist i go to saw a shadow on the pictures from the stress test which could indicate a heart attack (which he rules out) or blocked arteries -- he wants to do angioplasty -- I have no angina -- no shortness of breath - I seldom if ever tire easily and my quality of life is extremely good. I live independently, keep my house, drive, grocery shop, write articles and stories. A CT of my brain shows no mini strokes - some white matter issues --- i have recently been diagnosed with neuropathy in my feet - not diabetic - take large doses of B1 and B12 which seem to help --- should I consent to an angioplasty -- I don't think so - Thank you for your opinion.
E.H., New Smyrna, Florida, USA, October 12, 2011

• Paula in Florida -- There are methods used to dilute the dye and to pre-hydrate the patient so as to reduce the effects of contrast dye. This is of obvious concern in a patient like your mother suffering from kidney dysfunction. The big question is will these safety protocols be enough to avoid more damage. We have spoken of this issue with Miami-based interventional radiologist Dr. Barry Katzen in other regards. What you need to find out is what the interventional cardiologist or radiologist plans to do to keep your mom from more kidney problems here. We have faced a similar issue with a family member and -- it turned out his poorly-functioning kidney had a severe blockage, which was fixed -- with angioplasty!!
Angioplasty.Org Staff, Angioplasty.Org, September 10, 2011

• My mom had a heart attack in 2008. At the time they took a thigh vein out on the left side. The other side was 90% blocked and they said once she recovered she should have it taken care of. The contrast dye used damaged one kidney to 30% and the other is non-functioning, she has 30% use in one only. Now 3 years later they say she needs a stint in her right leg 95% blocked and they will again have to use the dye to place a stent. Should she have this done? If not will she die? Help please! We talk to kidney doc they say not to do and then heart doc says she must do... so confused and do not know who or what to believe. My mom in 75 years old, I see she is very tired now and can not walk a lot with out stopping because of the pain in her leg. I do not want to tell her what to do for fear of a bad outcome. Please advise.
Daughter Paula, Zephyrhills, Florida, USA, August 31, 2011

• Rema -- We'd suggest consulting his cardiologist. Do you know what type of stent he got? Is he having chest pains? There is a small chance that his stent may be getting reblocked -- stents, if they are going to start closing up (restenosis) usually do so in the first 6 months. Bare metal stents are more likely to do so than drug-eluting (medicated) stents, about 15-20% vs. 5-10%. But his shortness of breath may be due to any number of things and one should not jump to conclusions. Which is why you should discuss this with his cardiologist. And let readers of The Forum know the outcome.
Angioplasty.Org Staff, Angioplasty.Org, August 21, 2011

• my husband had heart attack 6 months back and he had 1 block in his right artery and angioplasty done removed block and 1 stent done and he was in medication but the last 2 days he is suffering with shortness of breath . What should i do / he is 72yr old diabetic too.
Rema, housewife, Kerala, India, August 21, 2011

• Aortic aneurysms are not usually repaired until they reach a bit larger than your mothers' -- about 5.5cm -- but the other problems may be informing the doctors' decision. You can read more about the endovascular repair with stent grafts of AAA's on our web site here. One early indication for the stent graft procedure is for patients too ill for open surgery.
Angioplasty.Org Staff, Angioplasty.Org, April 5, 2011

• My mother is 77 and very active (competes in ballroom dancing). She was admitting to the hospital with a serious urinary tract infection, a staghorn kidney stone, and an aortic aneurysm 4.5cm. After 2 weeks of consultation and antibiotics to treat the infection Drs have decided to remove the kidney first then treat the aneurysm with a special stent and may have to do a by-pass if she is not getting enough blood flow to her arm. Does anyone know of someone who has had this done under these circumstances?
Charmaine, Corpus Christi, Texas, USA, April 4, 2011

• Connie in Sacramento -- Angioplasty IS an alternative to surgery. And it can be done safely in an elderly population, too frail for open heart surgery. Chelation is not done because it has never been proven to be effective. Have you consulted an interventional cardiologist who could review your aunt's history and records and help guide you to the correct therapy?
Angioplasty.Org Staff, Angioplasty.Org, March 27, 2011

• i need help my aunt had bypass surgery already she now has 80% blockage of he arteries she can"t have surgery again we need away to remove this plaque I look at chelation using e.d.t.a. but they are not doing that any more do any one know of a treatment we can look at to save her life?
connie need a way to treat arteries blockage without surgery, Sacramento, California, USA, March 26, 2011

• My mother died in July after an angioplasty procedure. We had been advised by the cardiologist that it would be sensible for her first to have an angiogram and then it was thought she would benefit from an angioplasty. She had one blocked artery and one artery that had caused her heart attack. She had a build up of fluid before and a little after her heart attack which was considered moderate. She went ahead with the procedure having firstly wanted me to call it off, but I said that we should go to the hospital and the doctor would give her his advice and she could then say no if she decided against. From the advice given as her daughter it was impressed on me that it would be beneficial that she have it. Through a course of very unfortunate events, at the age of 87, she had the procedure, and then her kidneys failed and the end result was sepsis. I am extremely upset that we were not informed of all the complications, she was particularly nervous about having it done and I feel so let down by the advice given. Doctors have said the result would have possibly been this way even if the procedure had not taken place. Would she have been better to not have it.
Melanie von Berg, London, United Kingdom, November 9, 2010

• This topic is "Angioplasty and Stenting in the Elderly" -- which is really about patients in their late 70's, 80's or older. President Bill Clinton had stents placed earlier this year. He's in his 60's. No one would consider him "elderly". As for whether or not angioplasty is the right treatment, this is a complex issue. The various heart societies in the U.S. and elsewhere have developed guidelines for when medical therapy, stenting or bypass surgery are the best treatments. Be aware also that coronary artery disease is a chronic condition. Its progression can be slowed through medicines and lifestyle changes (i.e. stopping smoking, exercise, diet) and symptoms can be relieved by opening a blocked artery, but none of these treatments are "cures". Each patient is an individual with specific issues and clinical conditions, which is why diagnosis and treatment needs to be done by a cardiologist with access to the patient.
Angioplasty.Org Staff, Angioplasty.Org, September 10, 2010

• My father's age is 60 and last month he suffer from Heart Attack. Now he is in medicines, we had done angiography and came to know that one of his artery is blocked by 95%.Now I wanna to know that; Is Angioplasty is necessary or he will recover by medicines.
Neeraj, INDIA, September 8, 2010

• My mother is 71. She is not able to do any exercise due to severe arthritis, Her knee joint has no strength. However she is able to manage her routine. Now she has a mild attack a week back. Doctor suggested us to go for angiogram and then for treatment immediately. Is it possible to do angioplasty at this age and condition. Please suggest me all available solutions.
Forum heartcareindia, Mysore, India, September 2, 2010

• Laura from Long Island -- This site is about interventional cardiology. Bypass surgery is a different specialty (cardiac surgery), but success rates, etc. for any cardiac procedure really depend on many factors, age being only one. General health, condition of heart, anatomy, etc. all figure in. Mass General is certainly a highly regarded institution -- the surgeon doing the bypass should be able to discuss these issues with you more specifically, if you haven't already. While surgery is definitely a more traumatic procedure than angioplasty, in your mother's case with significant four vessel disease, CABG (coronary artery bypass grafting) would seem to be appropriate, assuming her health is good otherwise. Was angioplasty ever discussed?? The keyhole procedure simply is a less invasive surgery, where the surgery is done through a smaller opening or openings which lessens the trauma and doesn't require use of a heart-lung machine. However, it requires experience and greater expertise on the part of the surgeon.
Angioplasty.Org Staff, Angioplasty.Org, August 8, 2010

• My mother in law who is 77 is having quadruple by pass Tuesday. She has been doing well for the past 10 years after suffering a heart attack. 2 vessels are 100% blocked and the other 2 are 80%. She is having surgery at Mass General in Boston which seems like a good place. I wanted to know what the success rates are with a woman that age? assuming no additional complications? also can u tell me about the keyhole procedure and what the criteria is for being a candidate for it? thanks so much.
Laura from Long Island, Long Island, New York, USA, August 6, 2010

• RL from India AND BB from New Zealand -- doing a procedure on an 89 year-old with previous heart attacks (and presumably some heart damage) carries a greater than normal risk. Whether an interventional procedure like angioplasty would be helpful depends on several things -- for example, would opening the 70% blockage actually improve the blood flow to a part of her heart that needs more oxygen? That's a question that can be asked for any angioplasty done on a patient of any age, either 89 or 69. You should discuss these cases with your parents' interventional cardiologists (the specialist who does angioplasty) -- it may well be that they can derive sufficient benefit from medical therapy, without the possible complications of either surgery or angioplasty. But if angioplasty is indicated, it can be performed on elderly patients successfully by an experienced operator. And BB -- the question is what does your doctor mean by "heart giving way". If there are blockages that are causing ischemia and there is viable heart muscle, then opening the blockages should improve your father's status. But these kinds of diagnoses cannot be made long-distance. Talk to his cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, July 30, 2010

• my father is 69 and has suffered angina 10 years ago. angioplasty was done on him. now he is suffering from shortness of breath and the doctor said that his heart is giving away. he is very frail but healthy. is it safe to do an angioplasty again if required.
BB, New Zealand, July 28, 2010

• My grandmother is 89 years old.She had two heart attacks earlier. Doctor said her heart arteries are blocked (one 100% blocked and other 70%) Due to her old age bypass surgery is not possible. Doctor suggested some medicines, asked to consult after 15 days. I just want to know is there any other solution for this problem i.e. to unblock her blocked heart arteries.
RL, Haryana, India, July 24, 2010

• Johnnie -- Your dad is having his angioplasty today -- but it's not surgery. It's a catheter-based procedure during which the patient is awake. No general anesthesia is used during angioplasty, which is a good thing because that would be very risky, given your father's breathing problems. Assuming there are no complications, your dad should be fine, heartwise (he still, of course, has his pulmonary problems). But 64 is not elderly. President Clinton, your dad's age, just had two stents put in and was back at work, helping victims of the Haitian earthquake, the following day. Catheter-based minimally invasive procedures have opened up many treatments for patients who are not able, for various reasons, to undergo open surgery.
Angioplasty.Org Staff, Angioplasty.Org, July 7, 2010

• My concern is for my Father. He is 64 yrs. old & was always healthy (Last Dr. visit was 1995) up until March, 2010. He was hospitalized & diagnosed with COPD, Emphysema & Black Lung. Now he has to have stents. They said he had 80%. blockage around his heart. They want to do the surgery, Wednesday, July,7, 2010. Do you think this will be risky? How long does a person stay hospitalized after this surgery & how long to heal & be able to function again? Thanks so much.
Johnnie Anne, Prestonsburg, Kentucky, USA, July 5, 2010

• Stenting has been done successfully in many octogenarians.
Angioplasty.Org Staff, Angioplasty.Org, June 23, 2010

• my dad is 90 and in general has been healthy and active. he recently had some angina and shortness of breath. Now cardiologist said he appears at sometimes in the past has had some silent heart attacks perhaps 2. Some scarring is evident. He had bypass in leg years ago 3 times so some history of arterial blockage is there. Treatment so far is wait and see gave him sublingual nitrates and Lipitor. Revisit in a few months. Question is would stenting be appropriate at his age?
defino21, Fort Lauderdale, Florida, USA, June 16, 2010

• Was the radial (wrist) approach discussed at all. This would viertually eliminate the bleeding risk from the access site and allow greater use of "clot-busters" to prevent stroke.
Angioplasty.Org Staff, Angioplasty.Org, June 1, 2010

• My mother recently had a mild MI. The angiogram that followed caused a stroke. The clot busters cleared the stroke but caused bleeding from the angiogram insertion site and a large haematoma. She was supposed to have a stent fitted today as one of the coronary arteries is significantly occluded but when being consented was told there was a 50/50% risk of another stroke so she refused. What alternative treatment is indicated?
Boris, UK, May 24, 2010

• Najma -- Thanks for posting, but your father's condition is a complex one: complex because of his extensive blockages and complex because of his compromised clinical condition. The opinions of the interventional cardiologists and the cardiac surgeons (two different types of doctors) should be listened to and weighed. Perhaps a second opinion will help you decide. Bypass surgery is major surgery (unlike stenting) but when there is extensive and diffuse disease, it may provide a more lasting solution.
Angioplasty.Org Staff, Angioplasty.Org, May 15, 2010

• Hi my father is 72 he has severely 4 blocked arteries, vasculitus in legs and neck, hypertension and diabetic. they decided against stents as arteries too stiff but only option now is bypass but that has v v high risk, what else could be considered if we don't do bypass please Reply urgently. And what's this goodlife drug is it advisable and will it help? Pls reply
Najma Khan, London, United Kingdom, May 14, 2010

• Dee -- Is your husband having symptoms? Angina? If he is "doing fine", what is the reason he is being recommended for an angiogram? While invasive angiograms are considered low-risk procedures, there are risks to any medical procedure, and catheterizations are not normally indicated for asymptomatic patients, so your cardiologist must be concerned about something. We certainly cannot give medical advice (that's for your doctor only) but you might want to ask about a CT Angiogram, which takes a few minutes and is non-invasive, although it does require an IV of contrast dye.
Angioplasty.Org Staff, Angioplasty.Org, May 13, 2010

• My husband is 78 years old and had an angioplasty 13 years ago. His doctor insists he needs an angiogram . He has been doing fine all these years, stays slim and watches his diet. We are both concerned with the risks of an angiogram. Is is dangerous for him to put off the angiogram?
Dee G., Kentucky, USA, May 11, 2010

• I am 69 and have just had my third angioplasty. This after Coronary artery bypass and transmyocardial revascularisation. I am lucky to have a Ramus intermedius artery, present in some 20% of patients, as my right artery is totally occluded and my left artery is kept open by one small stent in the LAD. My impression is that stenting will most probably extend life but does make it less painful. I will accept that!
Ron Harsley, Sarasota County, Florida, USA, February 17, 2010

• These are decisions best made in partnership with her interventional cardiologist, assessing the risks/benefits for her specific clinical condition -- he/she can explain the limitations, difficulties (which vary from individual to individual) etc.
Angioplasty.Org Staff, Angioplasty.Org, January 31, 2010

• my grandma is 80yrs old and she also has the onset of dementia. do you think we should think about having this procedure done considering all the risks.
Jody Q., Rock Island, Illinois, USA, January 31, 2010

• Tiara -- any procedure, surgical or interventional, is risky on a patient with only one remaining artery (especially if it is already 80% blocked). There are interventionalists who specialize in these types of cases, however. They may utilize a cardiac assist device. Here's a story from New York Magazine of an 89-year-old conductor who received such a procedure from Dr. Howard Cohen of Lenox Hill Heart and Vascular Center in New York.
Angioplasty.Org Staff, Angioplasty.Org, September 15, 2009

• My 80 year old grandfather who has diabetes has had 3 heart attacks within the last 2 weeks. the doctor has sent him home on all 3 occasions with just medicine due to his age the risk of him having to go in and open his 3 blocked arteries is out of the question. he has 1 remaining artery which is 80% blocked and is in the emergency room as i write this, his home nurse advised my grandmother he was to be rushed to the hospital the doctor s medicine was WAYYY too strong.He pulse was too slow, ad his eyes were twitching, not to mention his stomach was pulsating at a very high speed. they don't seem to know what they are doing here with him his life is precious ...what are his options please ???
Tiara, Heart by Heart, Massachusetts, USA, September 1, 2009

• Cindy -- what procedure is in two days? With 5 stents and at age 82, she probably is not a good candidate for bypass surgery -- but the questions you ask are not ones that can be answered by anyone who does not know her and have her medical history in front of them.
Angioplasty.Org Staff, Angioplasty.Org, July 12, 2009

• My Mother is 82 and already has 5 stents. These were done at three different intervals since 1998. In 2008, she had an angioplasty and Dr. said he was not going to do anything at that time. She is now back in her home state after having knee replacement in December. She did well with that; however, did have atrial fibrillation that was brought under control by meds. She is fatigued, short of breath walking to mailbox and trouble in throat with breathing at times and takes nitro. How much of a risk? Dr. in Florida said she was not a good candidate ever for bypass. Anemic and low blood count had a blood transfusion when knee replacement. please advise , procedure in two days. thank you
Cindy Tanghetti, Oscoda, Michigan, USA, July 12, 2009

• My father is 94 and his cardiologist recommends a persantine stress test. What are the risks for his age? Are there any articles or research you can recommend for me to read regarding results and complications for his age group? I am also interested in information regarding coronary stenting for men his age.
SD, New York, USA, June 9, 2009

• My 89 yr old father has probable blockage and needs to consider an angiogram. He had bypass 15 yrs ago and has remained active with little other issues. Now, always totally out of breath due to fluid not being removed from tissue (so says the cardiologist that just saw him). Said his heart was doing 25% contraction and 55 was expected. He wavered on the choice of the angiogram/plasty vs. meds for a month. Any thoughts? Prior posts useful but never saw anything on the use of medicines.
Al T., Boulder Creek, California, USA, June 1, 2009

• Angiograms are certainly done on elderly patients. As with any medical procedure, there is always a risk of complications. The question is whether there is a less invasive test that will provide the information needed -- and also, how will the results of any test affect treatment?
Angioplasty.Org Staff, Angioplasty.Org, April 18, 2009

• hi, My father is 82 years old, having BP, can an angiogram be conducted on him?
jagadish, bangalore, India, April 15, 2009

• MD -- the problem is that the contrast dye used in angiograms and angioplasty places a burden on the kidneys. Patients with renal failure are therefore difficult to treat.
Angioplasty.Org Staff, Angioplasty.Org, February 1, 2009

• My dad is 87 years old, has a congestive heart and renal failure.The doctor recommended an angiogram for possible angioplasty. The doctor said that he has narrowing of the blood vessels and needs to be opened by angioplasty. Since he has a renal failure, he might go to possible dialysis because of angiogram. Is my dad a good candidate for angioplasty? He just had a heart attack few days ago.
MD, New York, USA, January 20, 2009

• Unfortunately contrast media used in catheterizations and even CT angiograms are problematic in patients with impaired renal (kidney) function. This makes interventional procedures that use such dyes very tricky. Given that he has CHF, the shortness of breath may be from fluid build-up, something made worse by his kidney problem. Has he ever had a catheterization or CT angiogram? Does he have symptoms that would indicate a blocked artery? The question always is will results of a test change therapy? What does his cardiologist say?
Angioplasty.Org Staff, Angioplasty.Org, May 10, 2008

• Is there any way my Father, who is 85, can be checked for blocked arteries in his heart? He has only one kidney functioning and congestive heart failure. He is always short of breath and takes breathing treatments such as spiriva, advair and nebulizer.
Genny, Georgia, USA, April 3, 2008

• Sivaprasad -- success is a relative term. No treatment has been shown to prolong life. But angioplasty is used very successfully to treat angina, or to stop a heart attack which is in process. Your mother's heart attack is in the past, so the reason to do any intervention (angioplasty, surgery, etc.) would be to prevent future problems. Her breathing problems may or may not be related to any heart disease. Let us know what the angiogram shows.
Angioplasty.Org Staff, Angioplasty.Org, March 14, 2008

• My mother is 69 year old. She has been hospitalised due to serious suffocation (breath difficulty). The Doctor-in-charge told that the ECG showed the symptoms of a mild heart-attack. She was advised for angiogram. If necessary angioplasty may be done. Please inform me the success rate of the treatment of a 69 year old patient.
Sivaprasad T J, Civil Engineering, Thiruvananthapuram, Kerala, India, March 8, 2008

• A.D. -- we were just talking with a man who had angioplasty at your mother's age. He was in very poor shape, with an already weakened heart and had been refused for surgery. Dr. Howard Cohen of Lenox Hill Heart and Vascular Institute in NYC did an angioplasty on him, using a special cardiac support device called the Tandem Heart. The procedure was successful. He is now 92 and is conducting an evening of symphonic music next weekend -- three hours on his feet!
Angioplasty.Org Staff, Angioplasty.Org, October 13, 2007

• My mother who is 89 was just told she needed a stent put in one of her arteries. Would any of you go thru this at that age? Any insights on what I should tell her? Thank you.
A.D., California, USA, October 9, 2007

• Natalie -- we're sorry for your loss. Again, we don't offer medical advice, but whether or not angioplasty would have helped could only be determined by tests like an angiogram (invasive or even a CT angiogram) and/or stress tests. But these procedures are what is known as "revascularization" procedures -- bypass surgery also -- their purpose is to open up blocked arteries so the heart gets a sufficient blood supply (oxygen). But without evidence of blockages, the answer to your question can't be known -- however your dad had a number of other types of heart problems (CHF, valves, etc.) which angioplasty doesn't address. As for chelation, there still is no evidence that it does anything helpful. Diagnosing heart disease is very important -- it is our hope that that use of less invasive diagnostic tools, such as Multislice CT Angiograms, will make it easier for people to get the appropriate treatments they need.
Angioplasty.Org Staff, Angioplasty.Org, March 16, 2007

• My dad had chf (LV dilatation) 35%-45% ejection fraction, leaky mitral valve, hypertension (25 yrs 160/80-200/80) & Type 2 diabetes (20 yrs) He passed away Jan 15/07 just shy of 77 yrs. His meds were accupril, renidil, nitro-patch, bisoprolol, novo-propamide, lasix, warfarin. The last 3 yrs were pretty tough for dad. After pneumonia/septicemia chf kicked in. He was stable for 2 yrs, when a persantine stress test was ordered. We cancelled it because he was very weak & was having trouble walking. My question is would he have been an angioplasty candidate? Or would you have just recommended medication. He stopped the bisoprolol 5 months before he died because of a resting pulse under 40. He said he felt better off it. A statin was never recommended. He died quickly from an MI (CAD) and was comfortable and still independent @ the end. In his early 70's he took chelation therapy, we're wondering if that would have been the time for the statin and angiogram?
Natalie Lobay, Okanagan Medical Centre, Kelowna BC, Canada, March 13, 2007

• BA -- we don't make any recommendations -- that's something best done by your doctors. We can point to the June 2006 issue of the Journal of Invasive Cardiology, which published a major two-part review of the question, "Percutaneous Coronary Intervention in the Elderly Patient", written by Chicago-based Dr. Lloyd Klein. (Angioplasty is also called PCI.) The conclusion was that the decision to go in this direction depends on a number of things -- advanced age is definitely an independent risk factor for complications from the procedure, and age is not numeric, but physiological. Other health factors are important to consider, as well as the potential benefits, such as improved quality of life. It's definitely a balancing act. Here's an excerpt from the summary paragraph:

"PCI in the elderly carries a higher risk of acute coronary and other vascular complications. Age is clearly an independent risk factor for more complications and periprocedural mortality. However, the magnitude of risk depends strongly on the presence and severity of associated angiographic and clinical factors associated with increased risk in every patient undergoing PCI, especially comorbidities.... PCI in the elderly improves quality of life, but there may be an early cost in morbidity to achieve this outcome. Therefore a critical and conservative assessment of strategy and risk assessment is appropriate. Careful case selection using sound clinical judgment based on the patient’s pre-illness mental status, physical condition, and quality of life is of paramount importance. Additionally, to further improve outcomes of PCI, interventionists should be mindful of the most likely complications and perform these procedures with attention to detail."

There are risks to any medical procedure. I'm sure most physicians would agree that bypass surgery would be too invasive for a 95-year-old, so the choices are medical management or angioplasty. The last sentence in the JIC article points to the need for special care and awareness of the types of complications that may occur in the performance of this procedure -- a good question to ask the cardiologist is how many elderly patients he has done and what his results have been? The benefits of PCI in improved quality of life are documented in studies -- and these benefits don't seem to be reduced by the patient's age. But, as with any procedure, the risk/benefit decision needs to be made. Hope this is of some help.
Angioplasty.Org Staff, Angioplasty.Org, February 22, 2007

• My father who is 95 just had a thallium stress test which shows blockage around his heart. Because he is mentally so sharp and still enjoys life, his cardiologist recommended an angiogram and possible angioplasty with stents. He has a pacemaker for an irregular heartbeat, has had congestive heart failure (under control) and an aortal aneurysm (under watch by the doctor). He does tire easily, has some shortness of breath and is on several medications including norvasc, plavix and zocor. He has never had heart surgery. Would you recommend angioplasty in a man of this age?
BA, Florida, USA, February 22, 2007

• Christian -- it's impossible to diagnose a patient at a distance and the best advice is what your interventional cardiologist suggests -- after all, he/she is the one who will be doing the procedure. Also, we are not medical doctors, so while we could look at the angiogram, we can't give out medical advice. Angioplasty can be done successfully on elderly patients, but of course, your father may have other medical problems which could complicate the effort. Again, we support you asking as many questions as possible of the interventional cardiologist you are seeing. If you are determined to pursue a second opinion, I am thinking of Dr. "Gus" Pichard, a fellow countryman of yours, who is the head of the Washington (DC) Hospital Center cath lab. Here is a web page for him: http://www.whcenter.org/body.cfm?id=1485 Good luck and best regards.
Angioplasty.Org Staff, Angioplasty.Org, February 9, 2007

• Hi, my name is Christian, I need your help from Chile. My father Eliseo (age 87) is a heart patient, recently he was a coronary angiography or Angiography, and the diagnose was not good, I am very worried and desperate I want if you can help me seeing the archives of the Coronary catheterization, and give me one opinion, or a diagnostic for your disease...The Doctor Carlos Deck (Instituto del Torax Santiago de Chile) said that the only alternative is to open 2 of its arteries but that is very risky. The archives of the angiography are of 9 MB. please if someone is interested He can can send me the email to send the file. thank you very much I wait for this answer.
Christian Jara, Santiago Chile, January 24, 2007

• My mother in law had a angioplasty after 2 heart attacks when she was 89 years old. She was an active and vibrant women, so the doctors felt that her quality of life would be maintained. They were right!! She lived to be 103 and remained independent and in good health (while frail towards the end) until she died.
Susie, New York, USA, December 28, 2006

• Terry -- we are not physicians here and cannot therefore give you "medical advice". Your questions should be addressed to your mother's cardiologist -- but we recommend specifically asking him/her what the risks are and what the possible treatment options are BEFORE the angiogram. You might ask why a 64-slice CT angiogram isn't being done. This test is non-invasive and carries virtually no risk. Studies have shown a very high negative predictability -- that is, if it doesn't show a blockage, there isn't one there. Read the article on CT Angiograms in our special Diagnosis & Imaging section. If she does have a blockage, is it affecting her and will opening it actually benefit her quality of life. This cannot be diagnosed long-distance, but you should feel comfortable that what your mother's cardiologist is recommending is necessary or has a significant likelihood of improving her situation.
Angioplasty.Org Staff, Angioplasty.Org, December 26, 2006

• Please urgent advise needed. My mom age 90 may need angiogram and possible stent/angioplasty or surgery. she has a history of stroke in her family, has had high cholesterol problem and has a blocked (70-100%) left carotid artery. I am concerned about her having the angiogram. should I be? What about the stent? She had a recent mild heart attack and has shortness of breath and extreme fatigue. She lives independently and is fairly active and is in otherwise good health. Thank you for your response.
Terry Jaffoni, Plymouth, Minnesota, USA, December 25, 2006

• My grandmother has had 2 [angioplasties] in the last 2 months. She is currently in the hospital now diagnosed with a pseudoaneuysm in her right femoral artery. She was supposed to come home Thursday after the procedure and hasn't been getting any better. She has also had 2 heart attacks in the last 6 days. I will keep you updated on her condition. She is 86 yrs young.
Sharon, Omaha, Nebraska, USA, April 23, 2006

• Jay -- While we are not an "Ask The Doctor" service and do not and cannot give medical opinions, we try to do what we can, so we are responding to your urgent message. The general opinion is that bypass surgery, in fact surgery of any type, should be approached very cautiously in the elderly. Bypass surgery is a pretty big insult to the system and requires a level of recovery that may not be applicable in many patients. While angioplasty requires less recovery, and is often done in the elderly, each patient is different and ultimately a physician experienced in the success of outcomes and familiar with the specific patient has to make these kinds of calls. Medical management can be successful in patients for whom a higher level of intervention is too risky. And remember, none of these treatments are cures, only "fixes". But again, this type of opinion can only be given by a cardiologist who has examined your mother and who has her specific records. Perhaps you'd feel more comfortable if you got a second opinion from another doctor in your area -- if only to confirm that the decisions being made are correct. Look for an interventional cardiologist -- one who does angioplasty on a regular basis. Remember, all medical procedures carry risks and complication rates -- which is not to say they should not be done if indicated. Good luck, and we hope we have been of some small help.
Angioplasty.Org Staff, Angioplasty.Org, July 5, 2005

• My mother recently experience her 2nd mild heart attack in about 3 months. The doctor recommended against having angioplsty because of her age = she is 93. He said the risks of stroke at her age and condition is very high. She suffered a 5% damage to her front heart muscles. He recommends returning to her home with the same quality of life which she now enjoys rather than risk a stroke. He says that she is not a candidate for bypass surgery. She lives in a retirement community in Texas without assistance and enjoys good quality of life considering her age. She has good mental capacity, but is becoming quite frail and walks with assistance from a walker. I need an opinion quickly. She is in ICU tonight and I will be speaking to her in the morning. Can you respond quickly?
jay willhite, Hesperia, Ca, July 05, 2005

• My 89 year old mother had quadruple bypass in 1991...in 1993 two of the 4 grafts had to be replaced. At that time the surgeon informed us she would not be able to have any more done to her heart due to the fact she had no more good veins to use. She recently had a heart attack and had an angiogram. It showed another blocked artery. Is she a good candidate to have angioplasty?
Mary Jane Dahl, Minnesota, USA, 23 Feb 2004

• my mother was 61 years old. during angioplasty her doctor teared her vein and after bypass surgery and being 27 days in I.C.U she died she had the history of mastectomy of her two breasts, and after bypass she had problem of breathing. so i want to know was she a correct case for angioplasty? also i should to say that her plug was in sharp turn of vein.
vida abedi, chemistry and chemical engineering research center of iran, Tehran, Iran, 7 Oct 2003

• I only find questions. How do I find answers? Would like to know statistics for psuedoaneurym in groin artery after angioplasty. How dangerous is such a condition? Radiologist has tried to close it by injecting surgical glue and been twice unsuccessful. Wants to try again on my 88 year old husband, but after he returns from a 2 week vacation. How dangerous is such a wait? What are risks?
Muriel P., USA, 10 Sep 2003

• I am interested in information regarding angioplasty for a renal artery for a 75 year old woman who also has a mitral valve problem with her heart. Could you advise me on the risks of this procedure? My mother also tells me her doctor will put a stent in if the test shows the blockage he believes is there. Does this mean that she has renal disease or damage? Should she consult with a doctor for renal disease prior to having this procedure? Should an out of town daughter be present for this procedure in case complications occur? What type of complications could arise?
Cynthia R., Charlotte, North Carolina, USA, 10 Aug 2003

• Please send me information on the risks of catherization and angioplasty on an 87 year old mother with dementia and osteporosis. She is presently in a nursing home and is having bouts of congestive heart failure. I am concerned about her quality of life rather than quantity. She once expressed her desire not to have to linger in a nursing home.
Pat Trulove, teacher, Laurinburg, North Carolina, USA, 27 Apr 2003

• Again, I am asking the same question as to angioplasty and stenting in the elderly. My husband is 82, had 4 bypasses in 1984 after 2 MI's. The grafts are now 18 years old and he is experiencing SOB (shortness of breath). Otherwise is in good shape. Not diabetic. Can someone please give some info or direct me to info regarding safety for this age-population.
Anne, USA, 23 Feb 2003

• Please help. My Gran is 90 years old, good heart and good blood pressure. She has a blocked artery in her groin and the doctors are considering angioplasty. She has no pulse in her leg and is verging on gangrine. What are the risks. Please help. Many thanks
Carol, California, USA, 12 Jan 2003

• I have almost the same question: My mother-in-law is 88 years old. Her doctor is considering an angiogram which would probably lead to angioplasty. She is diabetic, has asthma, has been on a lot of steroids which have caused her skin and her arteries to be very thin. She is quite dizzy in the mornings. She is allergic to Nitroglycerin. I'm concerned that an angiogram might injure her arteries. Can anyone give advice?
Helga Mukhar, Sugar Land, Texas, U.S.A., 27 Oct 2001

• I too am interested in angioplasty for the elderly. My mother is 88, has had 2 heart attacks in the past two weeks, and has senile dementia. She's been in the hospital since the first hear attack and is on blood thinners. In relation to the elderly: What are the dangers? the odds for success? for failure? for repeat procedures? What is recuperation like?
Glenna, Boise, Idaho, USA, 23 Apr 2001

• My father is 93 years old, end stage renal, and diabetic. He experienced a second mini-stroke this week. After ultrasound, the dr. believes it was caused by a piece of catheter lodged in his left carotoid artery. He wants to perform angioplasty to retrieve the catheter, but also doesn't know if it is securely lodged into the artery wall. What risks does this pose for my father. Is it better to leave the catheter where it is, at his age. Please provide information and advice.
Sue Craven, Sound Transit, Seattle, Washington, USA, 13 Mar 2001

• My father's doctor has advised our family that our father may have a high percentage level of blockage in his artery and would like for us to consider the angioplasty procedure. My biggest concern is my father's age. He is eighty years old. Could you provide the percentage of successful procedures for his age group?
ROBIN DAVIS, LINDENWOLD, NEW JERSEY, 6 Mar 2001

• Would you recommend angioplasty for an 88-year-old woman who has congestive heart failure, only one kidney, and is experiencing the onset of senility? What are the benefits to the patient? What are the risks?
Dolores Nims, Carrollton, Texas, USA, December 18. 1999

• I am interested in information regarding coronary stenting in the very elderly (geriatric) population, re: increased complications, etc.
C. Belkin, MD, Brooklyn, New York, USA, March 8, 1998

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