Best Angioplasty and stenting sir. Agra patients are really lucky to have you. You explain the procedure to the patient and relatives also very well. Thank you. Sir
Well thank you for the question Dr. Medical Management alone for such patients is futile in my opinion. I am guessing, we are discussing about the presence of the thrombus scenario in a patient. The reason is that in this particular case- the thrombus is well organized and "hard" (not exactly 'soft' as you might put it. Such type of thrombus do poorly with medical management alone and take a lot of time to clear, if they clear at all, that is. In a patient with ongoing chest pain, and no distal flow, with a not-soft thrombus, there is limited scope of medical treatment alone, and patient would require PCI asap, like in this case, to protect the myocardium as much as possible. About intracoronary tirofiban, I like tirofiban, and some use cangrelor, well, it all depends on a lot of factors. About the triple therapy, in this case, the patient was only kept on DAPT after adequate treatment with PCI. Triple therapy may theoretically sound better, but it subjects the patient to a massive amount of risk for bleeding. But yes, if the thrombus was soft, and the flow was non-limiting and patient pain free at the time, i might have gone with the approach that you were talking about. But in this case. The only right option was this one due to all the factors mentioned above.
Best Angioplasty and stenting sir. Agra patients are really lucky to have you. You explain the procedure to the patient and relatives also very well. Thank you. Sir
Thank you so much for thr kind words. There is no thing like appreciation.
Good job
Thanks
Amazing work sir...however, whats ur take on medical mx for such patients? Intracoronary tirofiban, and triple therapy for a month later..?
Well thank you for the question Dr. Medical Management alone for such patients is futile in my opinion. I am guessing, we are discussing about the presence of the thrombus scenario in a patient. The reason is that in this particular case- the thrombus is well organized and "hard" (not exactly 'soft' as you might put it. Such type of thrombus do poorly with medical management alone and take a lot of time to clear, if they clear at all, that is. In a patient with ongoing chest pain, and no distal flow, with a not-soft thrombus, there is limited scope of medical treatment alone, and patient would require PCI asap, like in this case, to protect the myocardium as much as possible. About intracoronary tirofiban, I like tirofiban, and some use cangrelor, well, it all depends on a lot of factors. About the triple therapy, in this case, the patient was only kept on DAPT after adequate treatment with PCI. Triple therapy may theoretically sound better, but it subjects the patient to a massive amount of risk for bleeding. But yes, if the thrombus was soft, and the flow was non-limiting and patient pain free at the time, i might have gone with the approach that you were talking about. But in this case. The only right option was this one due to all the factors mentioned above.