Nguyen Nguyet, 80, has several underlying health conditions, including hypertension, type 2 diabetes, lipid disorder, and heart failure, for which she is currently taking medication. She previously had two stents placed in her left anterior descending artery and right coronary artery in 2011 and 2017, respectively. Recently, due to declining health, she visited Tam Anh General Hospital in Ho Chi Minh City.

A 1975-slice CT scan revealed a 38 mm aneurysm in her thoracic aorta, a 20 mm aneurysm in a segment of her abdominal aorta, complete blockage of her left iliac artery, severe narrowing of both renal arteries, and 95% restenosis within a stent in her left anterior descending artery. Several other arteries in her abdomen, such as the celiac trunk and superior mesenteric artery, were also severely narrowed.

Doctor Nguyen Xuan Vinh from the Interventional Cardiology Center said that Ms. Nguyet's widespread arterial narrowing was extremely dangerous because it affected several vital organs, including her heart, kidneys, intestines, and lower extremities.

"The simultaneous narrowing of multiple arteries could be due to poorly controlled hypertension, high cholesterol, and diabetes, leading to the accumulation of atherosclerotic plaque, or potentially a congenital vascular issue," Dr. Vinh explained. The severe narrowing of both renal arteries also contributed to her elevated blood pressure, making it difficult to control with medication and causing acute kidney injury on top of chronic kidney disease.

Professor Vo Thanh Nhan, Director of the Interventional Cardiology Center, assessed that without prompt treatment, Ms. Nguyet faced a high risk of arterial blockage and severe ischemia, potentially leading to complications such as myocardial infarction, bowel necrosis, or stroke. Due to her kidney damage, Professor Nhan and his team planned three separate interventions to minimize the impact of contrast dye on her kidney function. Before the procedures, doctors optimized her kidney-related issues, blood pressure, and cholesterol levels with medical therapy.

Professor Nhan (right) and his team perform an intervention on a patient. Illustrative photo: Thanh Luan

In the first intervention, the team prioritized placing a new-generation drug-eluting stent in the coronary artery to prevent acute myocardial infarction. Post-procedure results showed the stent expanded well, adhering closely to the old stent and the arterial wall, restoring blood flow to the heart.

5 days later, the team addressed the blockage in the left iliac artery. Due to the tortuous nature of the blood vessels in this area, making access difficult, doctors used a hydrophilic guidewire with a special coating to reduce friction against the vessel wall, facilitating the passage of instruments through the blockage to place the stent.

14 days later, the team placed a stent in the renal artery. In all three interventions, Ms. Nguyet received local anesthesia and remained conscious throughout the procedures. She is no longer experiencing shortness of breath, her other symptoms have improved, her kidney function is stable, and she has no complications.

Professor Nhan said the aneurysms in her thoracic and abdominal aorta, along with the narrowed areas in other arteries, do not currently require intervention. Therefore, Ms. Nguyet needs to adhere to her medication regimen and attend follow-up appointments as scheduled so doctors can monitor her condition and intervene promptly if necessary to limit complications.

Ms. Nguyet needs to maintain a healthy diet, reducing salt, sugar, and saturated fats, and increasing her intake of vegetables, fruits, and lean protein sources like fish, chicken breast, and legumes. She should also engage in regular exercise appropriate for her abilities and maintain a healthy weight (BMI between 18.5 and 24.9) to improve cardiovascular and kidney function, as well as control blood pressure, blood sugar, and cholesterol.

Many cardiovascular diseases, especially atherosclerosis, vascular malformations, narrowing, or aneurysms, often have no noticeable symptoms. Doctors recommend everyone undergo a general health check-up at least once a year, especially those over 40 or with cardiovascular risk factors such as hypertension, diabetes, lipid disorders, or a family history of heart disease.

Ngoc Chau

* The patient's name has been changed