Angioplasty and Stenting in the Elderly

• 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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?
Forum Editor, 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.
Forum Editor, 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?
Forum Editor, 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.
Forum Editor, 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!
Forum Editor, 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.
Forum Editor, 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:

• 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.
Forum Editor, 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.
Forum Editor, 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.
Forum Editor, 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