Aa
occluded stent
This week I had repeat cardiac cath-I am 6 months post restent to the LAD-my initial stent in the LAD was a drug eluding stent and I was on Plavix for 8 months and 325 of asa- that was in 2004.Six months ago when I had a cath it showed I had a 90% occlusion of the LAD at the proximal stent and 80-90% of mid to distal stent, they restented with another DES, this week my cath showed I had a 40% occlusion of the distal stent. I have been very compliant with plavix and asa. Recently I have had increaseing shortness of breath and my doc told me I had a stiff left ventricle and placed me on Lasix,potassium and an ace inhibitor, and I do feel better. He told me my left ventrical end diastolic pressure was high. I am also on coreg and zocor and 60mg of Imdur. I guess I am frustrated. I did everything I was suppose to do for my health,LDL is 70. My symptoms are so vague I am not sure I will know when this stent occludes. My stress test prior to my last stent was normal 6 months prior. Has anyone had this experience and did your stent go on to occlude completely, The interventialist has already told me if this stent occludes I will need a single vessel bypass, they could probably do this off pump with a mammary vein. I also I am concerned that I am imagining my symptoms and my shortness of breath was in my head because now all my numbers are normal.
Thank-you
Thank-you
I had lad stent 6 months ago. I am having sob with some chest pain. My heart rate jumps up when I walk. I am currently wearing a 72 he Holter monitor. I don't know what to do. My first stent in the circumflex was done 9\71\2017. one year later i was having chest pain so sept 2018 I had another catch. All arteries were clear or mild disease. Sept 2020 I went to hospital with chest pain and sob. They did thallium treadmill all normal sent home. 6 months later April 2021 I'm 75% blocked in lad and another artery that branches off it at 70%. I got angioplasty in both and stent in lad. I'm still having sob and chest pain just chest pain is not quit as severe. I don't know what to think.
Anybody have similar problem would welcome responses
Anybody have similar problem would welcome responses
You have some very good questions. I have one stent in my obtuse marginal that has been there for two years and is widely patent (no stenosis), so go figure.
I have a theory as to the reason that a series of end to end stents restenose. I haven't read it anywhere but I still suspect this. This series of stents drops the pressure of the blood as the blood travels through them. All the plaque causing junk in the blood slows down, and has more time to adhere to the inside of the arteries and scar tissue created by the stents. Doctors can measure flow through these arteries while we lay there on the cath table, consciously sedated to varying degrees, but what happens to this flow when we leave the hospital and start bending, running etc. Engineers can calculate the flow from a large pump through a tangled mess of system piping. BUT the system flow resistance stays constant. Our system flow resistance could change a bit.
Stents actually injure the arteries. The balloons that press the stent (and plaque) into the walls of the artery is pressurized to around 230 psi. This is only for 7 or 8 seconds, but.....they don't the stent to take off and start surfing toward the smaller and smaller arterioles of your heart muscle.
Blood is like water and will flow through the area of least resistance faster. I believe and know for sure in my case, that this series of unfortunate events-uh I means series of stent ended up where they are, just to save my life. The cardiologist know not to arrange these stents to where you cannot have the diseased vessel bypassed. They are trying to prevent CABG on a relatively young person. One who already has CAD, and one that could theoretically out live one bypass.
Some people's stents stay open, or remain blocked very little. I think that they are in the minority, I don't know. Hospitals are not required to collect or save these data.
The GREAT state of INDIANA has passed a law that requires all hospitals to keep records of all mortalities and the cause of death, like CABG. What a novel idea, lol. Politicians are actually helping science. I'm sure some hospital administrators and docs are worried in Indiana.
What I get from your post is what if you develop 3 vessel disease? MID-CAB can't help that, so why not wait for traditional bypass? That is fine if you have the luxury of time, and CAD that is not so aggressive. I heard my surgeon state (on a web cast) that the mammary artery does not become diseased and blocked, and scientist do not know why. Well, I want that baby to feed my septum and LV soon!
Bcbs of Al. covers any state that has bcbs, and if in yon state the hospital/doctors are in the "network", no additional charges will be incurred. I pre certified going to the Cleveland Clinic for my 5/26/07 cath and stent, or the trip up there.
My last stent, placed in the very ostial LAD, protrudes out into my left main. I saw it on the monitor and asked the doc if this would impede flow to my left circumflex. He said we thought about that, but took flow measurements and it does not.
Had I known this was the last stent I could have in my LAD, I would have asked for bypass instead of another stent. I didn't find out about this being my last stent until I saw my home town cardio. I do resent the CC not telling me. Maybe they did while I was feeling too good, don't rightly know.
If I were you, I would call my insurance company just to know what the case would be, should you decide to have surgery.
I think that In the future, there will be more and better ways to clear blocked stents. The problem here is the fear of clumps of plaque being broke lose and heading onto the heart causing an MI, (I think). I have had rotoblational arthectomy to remove a calcified blockage from the junction of my left main and LAD (bifurcation) so as to make room for a stent. The cutting head came off the wire and was lose in my LAD for about 40 minutes, yikes.
I am going to make a post about and ongoing clinical trial, "NIH Launches Large Clinical Trial on EDTA Chelation Therapy for Coronary Artery Disease", when I feel better. Do you feel like **** all the time? C-r-a-p will be deleted, lol.
http://nccam.nih.gov/news/2002/chelation/pressrelease.htm
We should also have a poll here to see how many stents have been clear for how long and what type (brand) is/was it. It would help all of us with CAD I believe.
I have a theory as to the reason that a series of end to end stents restenose. I haven't read it anywhere but I still suspect this. This series of stents drops the pressure of the blood as the blood travels through them. All the plaque causing junk in the blood slows down, and has more time to adhere to the inside of the arteries and scar tissue created by the stents. Doctors can measure flow through these arteries while we lay there on the cath table, consciously sedated to varying degrees, but what happens to this flow when we leave the hospital and start bending, running etc. Engineers can calculate the flow from a large pump through a tangled mess of system piping. BUT the system flow resistance stays constant. Our system flow resistance could change a bit.
Stents actually injure the arteries. The balloons that press the stent (and plaque) into the walls of the artery is pressurized to around 230 psi. This is only for 7 or 8 seconds, but.....they don't the stent to take off and start surfing toward the smaller and smaller arterioles of your heart muscle.
Blood is like water and will flow through the area of least resistance faster. I believe and know for sure in my case, that this series of unfortunate events-uh I means series of stent ended up where they are, just to save my life. The cardiologist know not to arrange these stents to where you cannot have the diseased vessel bypassed. They are trying to prevent CABG on a relatively young person. One who already has CAD, and one that could theoretically out live one bypass.
Some people's stents stay open, or remain blocked very little. I think that they are in the minority, I don't know. Hospitals are not required to collect or save these data.
The GREAT state of INDIANA has passed a law that requires all hospitals to keep records of all mortalities and the cause of death, like CABG. What a novel idea, lol. Politicians are actually helping science. I'm sure some hospital administrators and docs are worried in Indiana.
What I get from your post is what if you develop 3 vessel disease? MID-CAB can't help that, so why not wait for traditional bypass? That is fine if you have the luxury of time, and CAD that is not so aggressive. I heard my surgeon state (on a web cast) that the mammary artery does not become diseased and blocked, and scientist do not know why. Well, I want that baby to feed my septum and LV soon!
Bcbs of Al. covers any state that has bcbs, and if in yon state the hospital/doctors are in the "network", no additional charges will be incurred. I pre certified going to the Cleveland Clinic for my 5/26/07 cath and stent, or the trip up there.
My last stent, placed in the very ostial LAD, protrudes out into my left main. I saw it on the monitor and asked the doc if this would impede flow to my left circumflex. He said we thought about that, but took flow measurements and it does not.
Had I known this was the last stent I could have in my LAD, I would have asked for bypass instead of another stent. I didn't find out about this being my last stent until I saw my home town cardio. I do resent the CC not telling me. Maybe they did while I was feeling too good, don't rightly know.
If I were you, I would call my insurance company just to know what the case would be, should you decide to have surgery.
I think that In the future, there will be more and better ways to clear blocked stents. The problem here is the fear of clumps of plaque being broke lose and heading onto the heart causing an MI, (I think). I have had rotoblational arthectomy to remove a calcified blockage from the junction of my left main and LAD (bifurcation) so as to make room for a stent. The cutting head came off the wire and was lose in my LAD for about 40 minutes, yikes.
I am going to make a post about and ongoing clinical trial, "NIH Launches Large Clinical Trial on EDTA Chelation Therapy for Coronary Artery Disease", when I feel better. Do you feel like **** all the time? C-r-a-p will be deleted, lol.
http://nccam.nih.gov/news/2002/chelation/pressrelease.htm
We should also have a poll here to see how many stents have been clear for how long and what type (brand) is/was it. It would help all of us with CAD I believe.
Thank-you for the info. I am not sure insurance wise if they would pay for surgery in another facility,surgery is avaliable at my hospital, however they do not have the minimally invasive procedure.I don't look forward to the thought of having my chest cracked, but I don't care to be meeting my maker anytime soon, I am only 56. My question is don't stents eventually occlude-wither now or later, if mine is this occluded in 6 months-40% of the 2/3 distal LAD and numerous minor areas of occlusion in the proximal lAD what are my chances that it is going to stop there ? I hate to be a pessimist but am not sure what my odds are.If you or anybody could share some info I would appreciate it.
Thank-you, frustrated.
Thank-you, frustrated.
Our conditions are really similar. To make a long story short, I have 4 stents in my Lad and cannot have anymore, or this would take away a or the, bypass "target" in my Lad.
I have an appointment for minimally invasive bypass surgery evaluation (MID CAB) at the Cleveland Clinic on 9/18. A cath on the 19th and hopefully bypass while I am there. I live in Alabama and will be staying at their Guest House while not in the hospital. The nurse tells me that they do the evaluation and bypass "all the time" with one trip to Cleveland. The MID-CAB can only be done on a "front of the heart" coronary artery like the Lad.
Like you, I do not want the boot to drop.....It is not "preemptive" surgery since I still have a 35% - 40% blockage in the middle of my lad, and disease in the distal end (what target?).
I faxed a letter to my cardiologist there, and the surgeon that does the MID-CAB procedures there, explaining all the reasons I need the surgery done pronto. The CC pioneered this surgery...
Would be glad to help with more info if needed,
Jack
I have an appointment for minimally invasive bypass surgery evaluation (MID CAB) at the Cleveland Clinic on 9/18. A cath on the 19th and hopefully bypass while I am there. I live in Alabama and will be staying at their Guest House while not in the hospital. The nurse tells me that they do the evaluation and bypass "all the time" with one trip to Cleveland. The MID-CAB can only be done on a "front of the heart" coronary artery like the Lad.
Like you, I do not want the boot to drop.....It is not "preemptive" surgery since I still have a 35% - 40% blockage in the middle of my lad, and disease in the distal end (what target?).
I faxed a letter to my cardiologist there, and the surgeon that does the MID-CAB procedures there, explaining all the reasons I need the surgery done pronto. The CC pioneered this surgery...
Would be glad to help with more info if needed,
Jack
I have a drug eluding stent-this time the taxsus,the first one was the cypher DES, my LAD was involved. I was just recathed two weeks ago, I went to the doctor this week and found out all the results. I have diffuse scar tissue in the entire stent in the LAD and 2/3 of the distal stent is 40%occluded. At this time they don't feel it is hemodynamically significant, but if it worsens I will need to have a single vessel bypass. Has anyone else had this experience and needed surgery ? In some respects I feel I am just waiting for the boot to drop. As you did, I waited a long time before and had alot of vague symptoms beofore t hey recathed me and found my stent was 90% occluded at the proximal aspect of the LAD and then that is when I was restented with another DES. I also now have a stiff "L ventricle" and am on numerous drugs to bring my pressures down in my heart so I am not so short of breath, and have to say the drugs have helped alot. I am only 55 years old, thin and active and work full time as a nurse in an ER. LAst time I waited to complain because I didn't want to cry wolf. THank you for listening.
Me too - I had my bare metal stents in my LAD occlude twice in a very short time span (less than 2 months for each occasion). During the first angio to remove the occlusion, the doc simply did the angioplasty because it was at a remote, small hospital and his available technology didn't allow him to do more. The 2nd time, the doctor put a DES under the bare metal stents, and I've been clear since (I think.......knock on wood). My symptoms were fairly strong, so I knew that I had a problem, and the first time I probably put it off too long and it was completely blocked (don't recommend this approach :-) I hope you feel better soon - but don't put off symptoms too long. Just remember, having a nuke stress test is non-invasive but pretty accurate. This is always my first step if symptoms start coming up. Take care!
Yep, same thing here. In my own experience, I think that restenosing stents are far more common than the studies show. Getting stents installed is just one step on the path to bypass surgery. Gives the docs something to do while they wait, and leads you to think that they are doing something beneficial for you.
As far as doing what you're supposed to do for your health, forget that. Go with moderation in al things. They say that clogged arteries are from what we did 30 or 40 years back, so any benefits from what we do now likely won't show up for that same 30 or 40 years. I'll be about 100 years old then, and I figure that's too old to be enjoying all this good health and unclogged arteries, etc..
As for imagining your symptoms----that's very possible--been there, done that. And the bad thing about that is that if you go in complaining of cardiac symptoms, the docs WILL find something cardiac that needs fixing. I have 2 stents that were installed because of imaginary symptom. I say this because hindsight is 20-20 . Looking back, I now see that my symptoms were nothing but fear, anxiety, and my imagination running wild.
Sorry to ramble. I think there may be an answer to a question in there somewhere.
Jim
As far as doing what you're supposed to do for your health, forget that. Go with moderation in al things. They say that clogged arteries are from what we did 30 or 40 years back, so any benefits from what we do now likely won't show up for that same 30 or 40 years. I'll be about 100 years old then, and I figure that's too old to be enjoying all this good health and unclogged arteries, etc..
As for imagining your symptoms----that's very possible--been there, done that. And the bad thing about that is that if you go in complaining of cardiac symptoms, the docs WILL find something cardiac that needs fixing. I have 2 stents that were installed because of imaginary symptom. I say this because hindsight is 20-20 . Looking back, I now see that my symptoms were nothing but fear, anxiety, and my imagination running wild.
Sorry to ramble. I think there may be an answer to a question in there somewhere.
Jim
Thank-you for your response.My occlusion is from scar tissue, and they are drug eluding.I don't think there is anything I can do to stop the inceased occlusion. I do exercise and if I push to hard I go into non sustained v tachl, so I know whay my limits are. I have chest pressure at rest as i did in February when my stent was occluded, always in the morning at rest..I haven't had anymore chest pain since my Imdur was increased a couple of weeks ago.
Are you going for a cath soon, if so good luck to you and I also will be watching for your posts.
Are you going for a cath soon, if so good luck to you and I also will be watching for your posts.
Yes, I had a very similiar experience, except I had thrombosis with a bare metal stent. Are your occlusions caused by thrombosis or cholesterol?
Franners, I do aerobics almost every day, simply to determine if I am getting SOB, and wear a Polar heartrate monitor and have developed my own 'stress test' formula... I get angina when my heart rate exceeds 105 BPM so slow things down, and can do 20 minutes when the arteries are open on a particular machine or walk 35 minutes without SOB. Hope that makes sense, it is something my doc and I have worked out Today I noticed both my heartrate and SOB symptoms were off, plus I had angina too soon, so I'm going in tomorrow. I've got a lot of stents plus two heart attacks, and I'm told the same as you, next trip involves by-pass. My advice is to try and stay on top of your condition with a well-planned exercise regimen, but keep in mind, I know nothing about your situation. Do keep us informed, I'll watch for your posts. We have a lot in common.
Franners, I do aerobics almost every day, simply to determine if I am getting SOB, and wear a Polar heartrate monitor and have developed my own 'stress test' formula... I get angina when my heart rate exceeds 105 BPM so slow things down, and can do 20 minutes when the arteries are open on a particular machine or walk 35 minutes without SOB. Hope that makes sense, it is something my doc and I have worked out Today I noticed both my heartrate and SOB symptoms were off, plus I had angina too soon, so I'm going in tomorrow. I've got a lot of stents plus two heart attacks, and I'm told the same as you, next trip involves by-pass. My advice is to try and stay on top of your condition with a well-planned exercise regimen, but keep in mind, I know nothing about your situation. Do keep us informed, I'll watch for your posts. We have a lot in common.
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