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How Safe is Rotablation?

03/11/2017 10:11 PM

Recently my father age 84 yrs underwent angioplasty , one stent fitted, but while fitting another the artery got dissected and suffered major attack. As per cardiac doctor, he said that when the wire was introduced, due to insufficient blood supply, the stroke occured, and that he was forced to pull off the wire resulting in stripping off the major artery, resulting in bleeding from mouth and ultimate death after 5 days.We asked to do bypass on 3rd day , when condition was improving, but they refused.

The blockage was almost 85-90%, but how can a mere 0.25 mm wire restrict blood flow and cause attack ? What mistake has taken place? Is there any control for the guidewire to align concentrically to the blood vessel? On what basis the medical association permits one to do rotablation and angioplasty?

Are there any strict norms here in india?

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#1

Re: How safe is rotablation?

03/11/2017 10:47 PM

Ravi, I am very sorry to hear about the passing of your father. My condolences.

I am not sure about India, but here in the U.S.A, I have seen life saving procedures not performed on the elderly because of insurance. It seems that insurance companies have the final say in what medical procedures are performed on somebody in advanced years, whether it saves a life or not.

Again, I am sorry to hear about the passing of your father.

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Guru
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#2

Re: How safe is rotablation?

03/11/2017 10:50 PM

My condolences on the loss of your father.

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#3

Re: How safe is rotablation?

03/11/2017 11:00 PM

At that age I am surprised they tried the procedure at all....usually they just go with blood thinners and oxygen....If he was on blood thinners and oxygen and was failing, they probably performed a last ditch effort, whether that was a wise decision is a judgement call, and made by the physician in charge....Your father was dying, he tried to save him, he probably would have died anyway....sorry for your loss.....

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#4

Re: How Safe is Rotablation?

03/13/2017 12:29 AM

Hi,my condolences to you.what i understand from your explanation is "is it a doctor negligence or accident"

During angioplasty procedure,

Sometimes, when the plaque is particularly hard, or is so narrow that the balloon can’t pass through it, rotablation may be used. Again, a very fine wire is guided through the narrowing.

After this, a special catheter (a thin tube) is inserted along the wire with a tiny drill at its tip, powered by compressed air. This drill is used to chip away at the plaque to gradually widen the narrowing. Once this has been done, a balloon can be inserted and the angioplasty can proceed as normal.

if you have the Video evidence of the operation experts can suggest you the right root cause analysis !

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#5

Re: How Safe is Rotablation?

03/13/2017 3:34 AM

This is not the place for answering this question. You need specialist advice for your region, and India.

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Guru
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#6

Re: How Safe is Rotablation?

03/13/2017 7:41 AM

Are there any strict norms here in india?

I'm sorry to hear that.

And that age, the risks and high, and they only attempt it because of the amount of blockage. But, that would have come from your dad.

My dad and (2) angioplasty, fist one in the 1980's, very painful. The procedure improved and the second one was less painful. He then had a double bypass.

The risk is yours, I'm sure the doctors stated that.

When my dad was in his early to mid 80's. By dad has painful gallstones stones, and the doctor will not operate on him due to his age. And they were too large and the shape of them Ultrasonic treatment the risks were too high.

He's 92 now.

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#7

Re: How Safe is Rotablation?

03/13/2017 10:54 AM

I am sure all of us are sorry for your loss of your father. It hurts. At least he did live a good long life, but for family it is never long enough, and losing them is always with grief and pain.

I too lost a dear friend who went under the knife, and never came out alive, due to what I am calling incompetence.

Even if we did know precisely how this happened, there is nothing we can do for your father now. Sounds like the doctor perforated the arterial wall with the wire (IMHO). That should not have happened.

Also, the wire procedure may have loosened off plaques and clots that could have led to stroke? That seems plausible.

As to the norms, it must be through a medical board that grants certificates of specialties in the medical profession, or else I should shudder to think otherwise.

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Guru
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#8

Re: How Safe is Rotablation?

03/13/2017 11:18 AM

Condolence to you and your family....

If you are looking for any justification or rationality to what had occurred, a qualified medical pathologist can always do an autopsy to form that expert opinion and fill-in that void for you!

Again I'm sorry!

Personally in my perspective any invasive procedures done at any age is always risky and dangerous!

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vsar
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#9

Re: How Safe is Rotablation?

03/13/2017 2:39 PM

I too am sorry to hear of your loss.

You have mentioned several things, that raise some really big red flags, and here in the US, would be grounds for a full autopsy. I am assuming that an autopsy was not done, since most of your questions would have been answered by one.

Firstly, and assuming that you have told us exactly as a Dr. has told you, any cardiac procedure which breaches the arteries on the heart itself, or the aorta would result 'ONLY' in internal bleeding, and SHOULD have necessitated them performing a repair to those arteries. That sort of procedure could not have even been done without fluoroscopy, and that should have immediately alerted them to a tear in the artery wall.

Secondly, (and, assuming the bleeding from the mouth wasn't from something else like an ulcer, and a TOTAL coincidence), as I mentioned before, those tears in the artery walls should ONLY have resulted in internal bleeding; which then, begs the question: Why was he bleeding from the mouth? The most obvious answer is that the VERY incompetent Dr. not only breached the artery wall; but, also punctured the lung! That too needed to be addressed immediately, before he left the surgical suite!

Here in the US that sort of incompetence would have lead to a monumental law suit, and a hefty settlement from their insurance company! The autopsy being the only evidence really needed. What your situation may allow for, I am clueless. I also assume, that the body has been cremated, and is not available to be exhumed, in order to perform one; or, that your laws make allowances for such anyway.

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