### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have had a single bypass with serious occlusions of other arteries that could not be bypassed, trying to control with medication. Right ventricular with a stint is now completely occluded. What are the best treatment modalities can be used to dissolve the plague

### output:

Hello! Thank you for asking on Chat Doctor! I understand you concern, and would like to explain that when judging the need for a new revascularization procedure, a comprehensive guide on decision-making would be the recent clinical symptomatology (is there evidence of ischemic angina or its equivalents, etc.), coupled with some functional and some imagine tests. Besides coronary angiography which is the standard for making evidence of coronary artery lesions, other tests like traditional exercise stress test, or any available myocardial perfusion imagine test (like for example Cardio lite, etc.), may be helpful to identify the possible ischemic consequences of any new coronary stenoses (confirmed on coronary angiography). If new coronary stenoses are present (on coronary angiography), and no collateral circulation is compensating blood supply deficits, coupled with clear evidence of myocardial ischemia (on perfusion imagine tests), then a revascularization procedure should be considered. Probably facing your prior medical history, the best revascularization option to be followed would be a percutaneous coronary angioplasty with eventually stent implantation. Nevertheless, the latter discussion is almost thoroughly a technical one, and depends on also by technical skills of the medical team, as well as by available techniques at the attending medical center. You should discuss with your attending cardiologist about the above-mentioned issues. Hope to have been helpful to you. Greetings! 