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Diagnosis And Treatment

Most people are unaware of the atherosclerotic process going on in their arteries. The condition usually goes undiagnosed until a person develops symptoms of blood vessel obstruction, such as the heart pain called angina. Angina is a warning sign that the atherosclerosis may become life-threatening. People with angina take medication and are usually monitored by physicians to make sure the arteries do not become completely blocked. Some angina patients are able to slow or halt the progression of atherosclerosis with proper diet and lifestyle changes, such as quitting smoking.

The atherosclerotic plaques can be visualized by a special x-ray technique. A slim tube called a catheter is inserted through an artery in the leg or other location until it reaches the plaque site. Dye that can be seen on x rays is shot through the catheter. When an x ray of the site is taken, the plaque can be clearly seen.

Currently, atherosclerosis in the arteries of the heart is treated with drugs, surgery, or a technique called angioplasty. Like the x-ray technique, angioplasty involves inserting a catheter through an artery. Instead of shooting dye through the catheter, the catheter is used as a "roto rooter" to open up the narrowed arteries. Some researchers have used anti-clotting drugs delivered through the catheter to dissolve clots.

Surgery is also used to treat atherosclerotic obstruction of he heart's arteries. Bypass surgery in which a section of an artery in the leg is used to "bypass" a section of a blocked coronary artery, can allow the heart muscle to again receive adequate oxygen. Because this surgery carries a risk of stroke and other serious complications, angioplasty and drug therapy, in conjunction with diet management, are tried first. If no positive results are found, surgery is performed as a last resort.

One problem with angioplasty is that the solution is often only temporary. The plaques return because angioplasty addresses only the plaques, not the process that leads to their formation. In the future, molecules that target the growth factors released by the platelets may be delivered directly to the plaques through special catheters. This treatment is some years away.

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