- 1. PROTECT YOUR HEART AND SAVE YOUR LIFE BY SAYING NO TO
ANGIOPLASTY
2. Prof. Nandu Bhide Consultant Cardiac Surgeon D Y Patil
University, Nerul Wanless Hospital, Miraj Aston university
Birmingham UK 3. Coronary obstruction
- Can be prevented or reversed
- The correct lifestyle is the answer.
4. Interventions
5. Angioplasty
- Tube passed via a peripheral artery to reach the lesion.
- The tube has a balloon at the end.
- At the site of the lesion the balloon is inflated.
- Stent placed in the hope to prevent collapse.
6. Bypass Surgery
- Conduit from before to beyond the lesion.
7. Role of medicines in lifestyle disease.
- Medicines neither prevent nor cure.
- Role is supportive till the obstruction is reversed.
8. Lifestyle modification
- The only and right answer to the problem.
9. The right lifestyle
10. Intervention
- In only half the patients.
- If the lesion is at a critical site
11. Choice of therapy
- Medicines are just supportive.
- Unproven therapies are dangerous
- Right lifestyle is the answer.
- All need right lifestyle.
- But if intervention is needed
then???????????????????????????????????????????????????????????????????????????????????????????
12. Attractive Therapy= Angioplasty
- But is it safe????????????
- Is it effective in long
term???????????????????????????????????????????????????????????
13. Angioplasty [PCI]
- Is the current use of PCI in multi vesseldisease
actuallyevidence based?
- Are the limitations andrisks of PCI explained to patients?
- Does it represent valuefor money?
- Do numerous/repeatPCI make economic or medicalsense?
14. Angioplasty
- Many previous "innovations" have been touted to be the
solutionto problems of restenosis. These have included direct
atherectomy,laser atherectomy, rotablater, brachytherapy which have
allbeen touted previously as the grand solution to
restenosis.However the hype for each has subsided over time.All
these have been shown to be ineffective. It is difficultto fool
nature in the reparative process of placing foreignmaterials in
small vessels.
15. Angioplasty
- You insert a foreign substance in the human body in PCI. This
is nothing but to give a new disease in exchange of old one.
16. Angioplasty
- Blood thinners compulsory after stent implantation.
- Patient has other organs too that may require surgery in
future.
- Then either you stop the blood thinners and die of heart attack
or
17. Angioplasty
- Immediate Risk of sub acute myocardial infarction after PCI
is37%.
- Magneticresonance imaging defineda mean loss of 5% of left
ventricularmuscle masstherefore function.
18. Angioplasty
- 700% more chances of re-stenosis.
- 150%more chances of death
- More adverse events related to heart and brain due to
angioplasty
19. Angioplasty- Cost
- Two studies have been carried out to compare the costs of
angioplasty and bypass surgery.
- One was NHS- UK other one was by joint study by researchers in
reputed US and British Universities in New York and London.
20. Angioplasty- Cost
- Both conclude that the real cost of angioplasty is way higher
than bypass.
- If you add the high death rate of angioplasty high incidence of
heart attack after angioplasty, the cost becomes phenomenally high
for angioplasty.
21. Bypass Surgery
- Patients own tissues used to re-vascularize.
- Complete re-vascularization.
- Takes care of Future lesions.
- Time tested. performed as it was on day one. More than five
decades around.
22. The evil
- Clinical trials manipulated to sell stents.
- The cardiologist is the gatekeeper, and thismay produce
aconflict of interest in terms of self-referral;
- The disingenuous presentation and inappropriate applicationof
results of randomized trials in highly select and atypicalgroups to
the whole population; and
- The result of what happenswhen evidence-based medicine
ischallenged by a multibilliondollar industry.
23. Chuen-Neng Lee, MDNUS Singapore
- There are many unanswered questionsconcerning drug-eluting
stents:
- Will the drugs stay on the stents forever?
- What happens whenthe drugs run out?
- What will be the effect of the coatingson the arterial
walls?
- Will the drugs weaken the fibrous capof vulnerable
plaquesnearby?
- Is there a risk of creatinga new disease by placing the
drugsinside the artery?
24. Editorial from the Mayo Clinic proceeding
- : "Medicaltherapy has been forgotten options in the current
mechanisticage of cardiology, in which, therapeutic results are
more oftenmeasured by percentage stenosis rather than by clinical
outcomesor long-term survival."
25. David P. Taggart, University of Oxford, Oxford, United
Kingdom
- Bypass surgery is the best treatment for the coronary patients
but the patient needs to know. Unfortunately the patient is not
informed about this fact by many of us and therefore denied the
chance of best treatment.
26. David P. Taggart, University of Oxford, Oxford, United
Kingdom
- Therefore it is our duty to educate the public so that they
become aware of the facts.
- This is the only way Out to save the patients from evil.
27. Spencer King at the end of theRITA II trials
- "We must be honest with ourselves as wellas our patients if
there is no evidence to support improvementin prognosis. The
patients need to hear and understand that.In advocating use of
drug-eluting stents, there could be situationswhere patients are
not fully informed about the prognosis interms of life span,
myocardial infarctionor potential long-term complications.
28. Conclusion
- Right lifestyle is the answer.
- Half the patients need only lifestyle modification.
- Those with critical lesion need intervention.
- Angioplasty is dangerous, ineffective and costly affair.
- Bypass surgery is the right intervention.
29. Thank you. 30. www.bhideheart.com 0-98-6957-5897 SMS
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