instruction: hello doctor my mother age 59 had an ischemic attack recently trop test positive cpu mb elevated she has had a bev for her mitral stenosis two years back she is currently in the icu on medicinal therapy anti thrombotics she underwent an angiogram yesterday report and video attached her ca is 100 percent chronically occluded lda and lex have 70 percent and 90 percent occlusion respectively I have the following questions what the chance that angioplasty can help the total occlusion in her lex will a newer technology like rotablator ivus increase chances of clearing the totally occluded artery we are in a center that does not have surgical facilities so a bypass surgery will require shifting her to a another hospital how safe is it to do angioplasty in this situation and would you consider it risky to shift her to a bigger city that will involve 5 hours of road travel after which we can wait followed by a 5 hour long flight
output: hello I am sorry to hear about your mother poor health condition there is a very good chance that angioplasty can help with the 100 blockage alongside a stent she is still young if she can adhere to lifestyle modifications and medications it will help rotablator or ives can definitely help with clearing the clogged arteries although they also will require tenting because the site of the clogged arteries have become weak and will require tenting as support in situations like this I advise angiography for my patient the recovery period is shorter and patients are able to live a quality life with modification of lifestyle and medication it is not safe for her to undergo the stress of traveling at this time