Has anyone ever had a Cerebral Angiogram?

My Father CAG(Angiogram) Report?

• My Father aged 74 yrs, with history of diabetes for more than 6 yrs. He was regularly getting chest pain from last 2 yrs. Doctor advised to under go CAG(Angiogram), report details: LMCA: Normal LAD: Type III vessel, mid segment mild disease, distal total occlusion DIAGONALS: D1- origin diseased followed by diffuse disease LCX: Tight lesion with diffuse disease OM: Diffuse disease RCA: Dominant, multiple irregularities with mild disease, PDA diffuse disease, PVLB mild disease LV ANGIO: Not done HAEMODYNAMICS: Ao: 170/80 CONCLUSION: # CAD: TRIPLE VESSEL DISEASE, FAIR LV FUNCTION # Can anyone help me to understand what it all means? If this is serious, can he overcome this problem with By-Pass Surgery?

• Answer:

  The best targets for surgical bypass are those arteries with tight(>75%) narrowing where the artery beyond the narrowing is relatively normal(free of diffuse disease). By these criteria the main arteries here(diagonal, Lcx, Om, Pda all have diffuse involvement and are not good surgical targets. The biggest artery, the Lad is totally occluded and cannot be bypassed. Because of the unfavorable anatomy I believe he is a poor surgical candidate. The fair left ventricular(LV) function on the other hand suggests that he is a pretty good candidate for medical treatment with antianginal and lipid lowering drugs. This is especially true if the LV is not only fair but but totally normal.