CABG versus angioplasty

[Hrt72]

Hi,

I just had angiography.

Findings:
1.  Distal left main has 75% stenosis extending into LAD.
2.  Type 3 vessel proximal LAD has 90% stenosis extending into diagonal, distal LAD is small size.

Advised CABG.  Would angioplasty be equally good option?

[Flycaster305]

Ed334 gave you the perfect answer.  There used to be a lot of debate on this board regarding which is better, but it generally is considered by patients that it depends of the circumstances.

Ed has had about 10 stents and has had bypass surgery.  I think I have about the same history.  

That said, when you have 'distal' blockages, and it appears to me you have two, they are extremely difficult to stent.  The blockages occur at the Y and a stent tends to stick out into the main artery.  Like the plumbing in your home, dirty or obstructed pipes tend to catch more crud.  The LAD is a particularly dangerous place to have a blockage

I'd suggest talking to the surgeon and discuss his/her history, and if satisfied, trust the doctor's judgement.

[ed34]

I think whoever you ask this question, you will receive a different answer. This is because different options tend to suit different individuals, yet there doesn't seem to be any way to predict which one.
For example, bypass surgery suits some people for many years, while others it collapses after weeks or months. Stenting suits some people, while in others scar tissue forms quite quickly in the stents blocking them.
If I could do my treatments all over again I would have stents first because they are less invasive and faster recovery. If they don't work, THEN go to bypass.