What is the next procedure based on the CT Coronary Angiography report?
Patient: HI, i have undergone PTCA in Jan 2011, recently i had done C T Coronary angiography done and the report is as below:64 SLICE C. T. CORONARY ANGIOGRAPHYOBSERVATION :- Coronary CT Angiography was performed on 64 slice CT rendered images. Poor imaging due to poor breath hold, hence multiple step artifacts are noted.CALCIUM SCORE :- LM - 0, LAD - 0, LCx - 0, RCA - 0. Total = 0.LEFT CORONARY ARTERYLM :- NormalLAD :- Stent noted in proximal LAD. Stented segment show calcific plaque causing moderate narrowing. Soft plque noted in prestented LAD causing moderate narrowing. Post stented segment also shows soft plaque causing significant narrowing. Distal filling is not satisfactory.D1 :- NormalSEPTALS :- NormalCIRCUMFLEX ARTERY :- Soft plaque noted in LCx causing moderate narrowing. Rest of the LCx appear normal.OBTUSE MARGINAL BRANCHESOM1 :- Poor opacification.OM2 :- NormalRIGHT CORONARY ARTERY :- NormalPDA :- Normal and arises from RCA.scanner. Plain and post contrast images were obtained. Thestudy was reviewed in multiplanar reformatted and volumeCOMMENT :- Total Calcium score = 0 Moderate and significant disease in LAD. Soft plaque noted in LCx. Right dominant circulation. Suggest : Catheter Angiography.Can you please suggest what would be the next procedure. Doctor: This report suggests that you have instent restenosis.the very fact that u underwent CT angio suggests that you have symptoms of angina.I strongly recommend that you should undergo cath angio and confirm degree of block in your LAD stent.depending on reports you may need further intervention or modification of medicines.my best wishes.