Coronary ct angiogram shows extremely high calcium score of 4242 and ~ 70% blockage one artery. next step cath angio. should i consider atherectomy?

Cardiologist: I suggest you allow the interventional Cardiologist choose the appropriate treatment. You def need a Cardiac Cath. During Cath a stent may be required, balloon angioplasty may be required, or referral for bypass.

NO: You need a coronary angiogram-depending what it shows, you may need revascularization. Depending on location and extent, you may need surgery. Otherwise, balloon angioplasty followed by stenting is the treatment of choice. Atherectomy has a very limited and specific indication. If you need it, your interventionalist is the one to make the call.

Angiogram: Coronary CT can demonstrate blockages in arteries, however, it cannot measure blood flow. You can have good flow with a stable plaque in an artery that is 70% narrowed, and poor flow in one that appears less blocked but has plaque that is soft and likely to break off and cause a stroke or MI. You will get the info you need from your cardiologist after your angiographic study.