Cypher Stent Problems???

[Lenin]

Connie,

I'm of course citing mostly the "don't worry" data, but the fact is the data is inconsistent and inconclusive, except to show that if people don't take aspirin and/or Plavix, they are at a higher risk of blood clot. But that is also true if they have a bare metal stent.

Or indeed, none at all.

A couple things had me scratching my head:

The Ong study of about 2000 patients showed 8 incidents of late stent thrombosis in 7 patients: three "related to complete cessation of antiplatelet therapy

I knoow it is first thing in the morning for me...just ONE sip of coffee, but doesn't that say that 5 cases of late stent thrombosis were NOT associated with complete cessastion of antiplatelet therapy...so those who stopped the meds had significantly fewer untoward clot events? (I know, I guess it depends on how MANY quit the antiplatelet therapy.)

It DOES point out though, that exactly HOW resutls are presented reflects whether Plavix is less or more "good." :

I'm going to let you become our "super-expert" on the stent clotting issue. When you tell me to worry, then I'll start worrying. Actually, there's little point to worry because I guess the only way to REMOVE one of these suckers is with bypass surgery...sheeesh...some choice!
Probably, like KenKeith, I'd opt to medicate any further blockages, (but I'm not going to GET any...that's the BEST way to deal with them! )


This stent brouhaha has GOT to be spurring advances in atherectomy.If I were a young cardiac surgeon, THAT would be my speciality for sure. Removal of plaque has to be better than just squooshing it aside.

[started04]

Lenin: Unfortunately, the question you asked cannot be answered by those who suffered fatal heart attacks or strokes from a thrown clot.

Referring to a stent clot: When one dies unexpectedly with an unknown cause and no doctor's certification, the state has hired a medical examiner to investigate and record findings. A clot in the brain, artery, lungs, kidneys etc. is very very easy to detect and results are distinquishable... available to any interested party (may require a court order).

If it weren't detectable, ME's would be out of business!!...almost all medical procedures, number of deaths, cause of death, standard of care, treatment, duration of illness, etc. is part of a database with some agency, gov. bureacracy, hospital study, etc. There is almost no place to hide deficiencies or mistakes by the medical community! At least not any pattern of the same. Some deaths from poison, etc. are difficult to detect so the certification would listed as unknown. Clots don't fall into that category.

[Connie122516]

Originally Posted by Lenin

I'm going to let you become our "super-expert" on the stent clotting issue.

Oh, oh, that's a very scary thought

Originally Posted by Lenin

Actually, there's little point to worry because I guess the only way to REMOVE one of these suckers is with bypass surgery...sheeesh...some choice!

I'm not even sure that is possible...they might bypass around the sucker, but I doubt they'd cut it out???

I prefer to remain as blissfully ignorant of such things as possible; I couldn't even bring myself to do more than skim your "Where does the plague go?" thread as I did NOT like the idea of the artery bulging out (brings thoughts of an aneurysm waiting to happen to my "worst case scenario" anxious mind).

[Pwarbur]

OMG now I am even more nervous! I am the orginal poster Godsproperty..but for some reason the healthboard is not recognizing my name, so I had to slip in incognito. Well since I posted, I am getting my original pre-stent symptoms..jaw pain..shoulder pain..shortness of breath..the works. I am due to have a heart ct scan this thursday..but the dr told me it was about as accurate as a stress test and I've always passed those. I am afraid to get yet another cardiac cath..cause I've had so many in the past year and a half. Now another dr tells me my liver enzymes are elevated due to the vytorin I am on.. I am on plavix and aspirin indefinetly, and that in itself is a whole other problem. I dont know which way to turn. Seems like the things that are supposed to make us better are actually killing us. Ugh!

[Lenin]

I am getting my original pre-stent symptoms..jaw pain..shoulder pain..shortness of breath..the works. I am due to have a heart ct scan this thursday..but the dr told me it was about as accurate as a stress test and I've always passed those.

Pwarbur,
It sounds most like your stent is re-clogged (furred.) I think you will need yet another angiogram to confirm this.
If it were I, I would aske the cardiologist to consider re-anglioplastying inside the stent or else atherectomying it to open it up if indeed that's what he found.
I don't think an MRI will yield enough information.
How low are you keeping your LDL?
Until this is resolved, keep taking the Vytorin regardless of the liver enzyme elevation. Problemo UNO is getting and keeping that stent clean.
If you have always passed stress tests, how did they find the angina problem?

My case was a complete blockage (99%+) of the RCA and I was operating ONLY on small vessel shunting aroung the blockage. If my original symptoms returned I would judge that my RCA had again completely blocked and the collateral circulation was carrying the load.

edit:
I reread your first post...5 stents..OY. My thinking: your symptoms probably came from ONE of those blockages and that is the one that is likely reblocking and causing the same symptoms. An angiogram is the ONLY way to isolate which one is a problem.
But to back up a bit, why not have a nuclear stress test first to isolate WHERE the ischemia is...maybe that will help point to the offending stent.
(Sorry if this comes accross as a bit "stream-of-thoughty...just thinking out loud (or typing out loud.)

But LASTLY, remember (and I will too) that angina is a SYMPTOM not a disease. As such it can be dealt with symptomatically and for some people the symptomatic relief is often good enough. Perhaps too many people are having massive intervention when conservative treatment is good.

Has anyone seen recent results comparing those who treated angina with beta or cc blockade and statins compared with those who were stented? Probably the results would be hard to come by in this era of "stent-first, ask questions later."