Top

20

Doctor insights on: Drug Eluting Stent

Better: Then bare stent? Yes. Good patency rates. Be sure to take your Plavix (clopidogrel) or Effient after. I have one in my lad. ...Read more

Watch your platelets: You need two anti platelet drugs to protect from the stents getting thrombosis with blood clots. The length of time required keeps getting shorter and shorter. A thrombosed stent is a heart attack. ...Read more

Can : Form restenosis at about 9 months so need to be checked. After that they can last several years. Need follow up. Make sure to take your blood thinner. ...Read more

See below: The highest risk of restenosis is during the first month after stent placement. The risk of restenosis of drug eluting stents is about 10% vs bare metal stents of about 30%. After one year restenosis is much less common. Risk factors for restenosis include diabetes, small vessels stented, long lesions stented and multiple stents placed. ...Read more

Stent: You need to discuss stents with your interventional cardiologist. The various stents available have subtle differences which make different operators prefer different stents. There is no stent which has markedly better results than the others. ...Read more

No: with a Xience you need at least 6 months of DAP. No compromises on that PLEASE, until unless your doctors have told you something otherwise.. ...Read more

Place new stent: In old stent. Sometimes need a covered stent. Others just balloon again. ...Read more

Possible: But another medication such as Effient may be a better alternative. Did you receive a drug eluting stent or was it bare metal? ...Read more

What's your Question: Looks like your numbers are pretty good with a good drug regimen. See your cardiologist, looks like he is doing a good job! ...Read more

2 main ones: The 2 main problems with stents after placement are: 1) stent thrombosis where the stent clots off abruptly causing heart attack and risk of death, and 2) renarrowing of the stent. Renarrowing occurs in 5% of medicated stents and approximately 20% of unmedicated stents. ...Read more

Smoking in CAD: Secondary prevention guidelines emphasize smoking cessation for good reason. One's chance of a future cardiac event is worsened by continuing to smoke. Since someone with a stent already knows that they are at higher future risk (they are compared with someone without CAD history) then doing everything possible to reduce thy risk (like quitting smoking) is important. ...Read more

Depends on location: Stents are used to treat various amounts of blockage. There are locations that develop restenosis more than others after treatment with balloons and stents. Medicated stents are designed to prevent this restenosis. In smaller vessels such as heart vessels there is a proven benefit. In larger, peripheral vessels no benefit has been shown compared to regular stents. So it depends. ...Read more

An important tool: CLopidogrel reduces the incidence of both heart attack and stroke. TI helps by reducing the 'stickiness" of platelets which are essential for clot to form. IT is one of several drugs, including aspirin, that can function in this way. Patients who have not have stents can take either of these with good results. Patients with stents usually take both aspirin and clopidogrel for at least 3-6 months ...Read more

Yes: Most would recommend 12 months of Aspirin and clopidogrel after coronary stent, followed by Aspirin indefinitely. In some patients shorter or longer duration of treatment with both may be recommended. ...Read more

More potent: Plavix (clopidogrel) now has competitor drugs. Effient (prasugrel) is more potent at inhibiting platelets, which prevents clots, but this also leads to higher bleeding risk (double-edged sword). Ticagrelor is another agent with proven benefits similar to Plavix (i.e. Heart attack risk reduction), and seems to be more potent without increasing bleeding, but verdict is out still. ...Read more

↓ Blood Clotting: Plavix (clopidogrel) inhibits platelets (usually the first step in blood clotting) from becoming activated: sticking to tissue, attracting other platelets to stick & activating the 12 clotting proteins (which act in a chain reaction) to form thrombin which polymerizes & ties everything together into clots. Plavix (clopidogrel) has no affect on blood viscosity; it is an anti-coagulant; it does not thin blood viscosity. ...Read more

Liver activation: Plavix (clopidogrel) is a pro-drug which is inactive. upon oral administration, Plavix (clopidogrel) is activated in the liver to become the active drug, injection of Plavix (clopidogrel) will bypass the liver activation of phase of the drug. clinical studies of Plavix (clopidogrel) were done with oral administration, there are however other medications used in the hospital setting that are injectable, however used in the setting of heart attacks ...Read more

Heart vessel therapy: Percutaneous transluminal coronary angioplasty (PTCA) is the opening of blocked heart arteries with a balloon. An artery is stuck and a wire is passed in the system until reaching the heart arteries. A balloon is passed over the wire to the area of blockage and inflated. The blockage is flattened but it can return. So most patients actually get stents placed. Stents require blood thinners. ...Read more

Yes: be carful about bleeding because there is no antidote for these new agents. ...Read more

Severe: Generally the more disease the more likely we are to do bypass rather than multiple stents. This is not a universal truth however. ...Read more