Plavix and bare metal stents
Common Questions and Answers about Plavix and bare metal stents
plavix
Hi Steve, my sister and son in law each have TWO bare metal stents (2000). They were on Plavix for 2-3 years and neither of them have had any issues with their bare metal stents. It has been 8 years now.
On the other hand...I had 2 Cypher Drug Eluting Stents placed in the LAD and One Cypher DES placed in the RCA and ONE TAXUS Drug eluting stent placed in the RCA. (2004-2005) Last month, Cath doctor noted the TAXUS Drug eluting stent was nearly closed.
I have a drug eluting stent implanted in 2006. I have now been on Plavix and aspirin for over three years. The cardiologist says I will be on it for "life". If the use of Plavix and aspirin can be eliminated after 2 to 4 months of the implantation of a bare metal stent, why can't Plavix and aspirin be eliminated after a year? At what point does the drug eluting process stop so that the drug eluting stent becaomes the same as a bare metal stent?
My husband has a pacemaker and 8 metal stents. He's been taking Coumadin and Plavix for the past 4-5 years since his last stent was put in. Recently he was rushed to the hospital with blood in his vomit and stools. They said he had last 60% of his blood and immediately preceeded to give him blood, total 9 pints. After much reading up on ulcers and his medicine's side-effects, we discovered that Plavix causes ulcers. He was bleeding from a huge ulcer in his stomach.
If they find nothing, then my surgery will be kept on schedule, if they find a blockage I was told that this time I will receive bare metal stent(s) and that this will push my surgery off at least another month...My Orthopedic surgeon was very specific in me stopping both the aspirin and Plavix totally to prevent any kind of excessive bleeding...I trust him and his work as he has a great reputation, but I am troubled that this will be an ongoing problem with blockages throughout my lifetime...
I've only heard of two. This is usually when the first stent was a bare metal variety and has formed scar tissue, causing restenosis. Then a drug eluting stent is inserted inside which is coated with chemicals to inhibit scar tissue formation. I know that bare metal stents are cheaper but I really don't know why they don't bin them now.
some stents are coated to prevent restinosis (blockages) and some are bare metal stents, but sometimes the coated stents will plug up, especially if one isn't taking a blood thinning drug. I have both. Coated stents are thicker and because my heart arteries are small, most of my stents are bare metal.
I'm betting this is confusing to you. It's a confusing issue. My suggestion is to become as well educated as you can regarding Cardiac Artery Disease (CAD).
After a year there is no evidence to suggest plavix has any benefits as the stent is well embedded in the artery lining by then. However, this is related directly to benefits affecting stents, because both plavix and aspirin will continue to reduce clotting times in your blood as long as you take them. I am on plavix for life and not aspirin, because aspirin gave me too many gastric issues.
I had 3 medicated stents implanted a year ago and was prescribed 75mg of Plavix for the same period. I have asked my doctor if I could stop and he told me that it may collapse the stents. Is it true? Recently I developed excessive gas and uncontrolled flatulence which subsided when I stopped taking Plavix for 9 days to take a colonoscopy so I would like to stop taking this pill.
I have three stents; 1 bare metal in LAD and 2 DES in RCA since Feb 2007 after having an M.I.
Vascular surgeon wants me to stop my Plavix/Aspirin in a week to have balloon angioplasty performed on lower extremities due to blockage in leg. I am scared to death of stopping the meds because I have read in this forum that abruptly stopping can lead to another MI within days. Is there any truth to this.
Compared to the alternative bare metal stent and it is known that the likelihood of the arteries re-narrowing after drug-eluting stents are much less than after bare metal stents. But the drugs for DES are very potent compounds, and sometimes they cause the artery to heal to a minimal degree. And occasionally blood clots can form on drug-coated stents.
Drug eluding stents (DES) are more susceptible to restenosis than bare metal stent up to about a year or more. Studies have shown and the consensus is to medicate with Plavix and aspirin for that time period. Both medications are anti-platelete agents but have different mechanisms to prevent clotting and the doctor has no fault.
d urge you to start some form of exercise, quit smoking or using tobacco in any form, and stay on a low cholesterol diet, and try to reduce stress in your life. I have eight stents, five of which are bare-metal, and only one plugged up enough to give me problems after three months. I wouldn't worry about it, stress is your worst enemy right now! Best wishes.
13th I had a major heart attack and SCD. Was sent to the heart hospital where two stents, one bare metal and one drug eluding, were implanted in the LAD. Five days later a pacemaker/defibrillator was implanted. The next week I was hospitalized for a blood clot near the area of the implant, then back into hospital for AFib, after which I had an infected right arm from the IV. Three months ago I had a very infected left breast, also many cysts-- which is not unusual for me.
1. Outcomes associated with drug-eluting and bare-metal stents: a collaborative network meta-analysis. The Lancet 2007; 370:937-948
http://www.thelancet.com/journals/lancet/article/PIIS0140673607614445/abstract
2. Effectiveness and Safety of Drug-Eluting Stents in Ontario. N Engl J Med 2007; 357: 1393-1402, http://content.nejm.
13th I had a major heart attack and SCD. Was sent to the heart hospital where two stents, one bare metal and one drug eluding, were implanted in the LAD. Five days later a pacemaker/defibrillator was implanted. The next week I was hospitalized for a blood clot near the area of the implant, then back into hospital for AFib, after which I had an infected right arm from the IV. Three months ago I had a very infected left breast, also many cysts-- which is not unusual for me.
The reason for plavix is that DES has a tendency to clot when compared to bare metal stents, and less a problem for restenosis (overgrowth of tissue within the lumen). After a year medical consensus is to discontinue plavix as there is less risk for clots, but continue with aspirin for a lifetime.
There may be some individuals that have a higher risk for clots so plavix may continued indefinitely.
so I assume you had bare metal stents inserted? These are notorious for restenosis, hence the large amount of research and development that went into producing the drug eluting stent, which inhibit scar tissue growth in the stent far more significantly. What options do you have? well, there are just three as far as I can see. First is to try and give a better flow through the bypass conduits by stenting them. Second is to do another bypass procedure.
Restenosis is not really a thing of diet, it is usually due to the artery growing too much scar tissue which grows through the tiny holes in the stent. There are two types of stents, Drug eluting and bare metal. Drug eluting ones have a special coating of chemicals which inhibits scarring. Bare metal stents are much more likely to suffer restenosis. Maybe the second stent was a bare metal one and they believed that there was not enough lesion to be of concern.
13th I had a major heart attack and SCD. Was sent to the heart hospital where two stents, one bare metal and one drug eluding, were implanted in the LAD. Five days later a pacemaker/defibrillator was implanted. The next week I was hospitalized for a blood clot near the area of the implant, then back into hospital for AFib, after which I had an infected right arm from the IV. Three months ago I had a very infected left breast, also many cysts-- which is not unusual for me.
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