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Cholesterol & Triglycerides Health Center

Treatments for Advanced Atherosclerosis

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Drugs are usually the first choice of treatment, even in the late stages of atherosclerosis. Sometimes, though, more aggressive treatment is needed.

Narrowed arteries can frequently be reopened with one of two treatments: stenting or bypass surgery. Because these atherosclerosis treatments come with risks, they are typically reserved for emergencies or when medications fail.

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Achieving lower cholesterol is one of the best ways to protect yourself from heart attack and stroke. A fat-like substance found in the blood, cholesterol can build up and form deposits in your arteries. These cholesterol deposits can clog arteries -- or in some cases completely block -- the passage of blood and oxygen to the heart. The result, for hundreds of thousands of people every year, is chest pain, heart attack, or other cardiovascular problems. There are two kinds of cholesterol:...

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1. Angioplasty and Stenting

A coronary angiogram is a special X-ray test that doctors use to identify coronary artery blockages and sometimes take action to open them up. In an angioplasty, a doctor first introduces a catheter (a narrow tube) into an artery in the leg or arm. The catheter is then moved to the area of concern. Usually this is the coronary arteries in the heart, or the arteries in the legs or brain.

By injecting dye that is visible on live X-ray screens, the doctor can see blockages in the arteries. Using tiny tools on the catheter tip, he or she can often open blockages.

A stent is a tiny cylinder of wire mesh. During an angioplasty, a balloon on the catheter tip is inflated inside a blockage to open it.  Stents can be placed during this process and are left behind once the balloon and catheter are removed.

Stents can relieve chronic symptoms of chest pain (angina), or reopen a blocked artery during a heart attack.

Coronary angioplasty with stenting has a low complication rate. The recovery time is often less than one day.

2. Coronary Bypass Surgery

In bypass surgery, a surgeon "harvests" a segment of a blood vessel from the leg, arm, or chest. He or she sews this healthy vessel onto the coronary artery, rerouting blood around the clogged artery.

Coronary artery bypass surgery -- or CABG (pronounced "cabbage") -- is the most commonly performed bypass surgery. CABG can provide relief from chest pain caused by atherosclerosis. Bypass surgery also leads to increased survival in people with multiple or severely blocked coronary arteries.

As you would guess, CABG is major surgery. Although low overall, the risk of serious complications is similar to coronary stenting. The recovery time can take weeks, even months. Newer less-invasive forms of CABG, with shorter recovery times, are under evaluation.

Is This Normal? Get the Facts Fast!

Is Your Cholesterol Level Heart Healthy?
What is your LDL (low-density lipoprotein) level?

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Answer:
Desirable
0-199
Borderline
200-239
High
240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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