Stent Thrombosis: An important complication after heart stents. Part 1.
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- čas přidán 20. 06. 2024
- Heart Stent Thrombosis is a concerning condition that arises when a blood clot forms inside a stent placed in the coronary arteries, potentially obstructing blood flow to the heart muscle. Understanding the intricacies of this condition is of utmost importance to ensure the long-term success of coronary interventions and the well-being of patients. Fortunately this complication is uncommon yet it does carry a considerable risk to the patient.
In this episode, Prof. Barlis breaks down the various classifications of stent thrombosis, emphasizing the importance of early detection and appropriate treatment. Furthermore, we delve into patient-specific factors that can contribute to the likelihood of this complication, including individual medical history, lifestyle choices, and other relevant health conditions including diabetes and kidney disease.
By enhancing our knowledge about stent thrombosis we empower ourselves and our loved ones to be vigilant about any potential signs and symptoms, and to collaborate effectively with healthcare professionals in ensuring the best possible outcomes. As always, Heart Matters provides general educational information, for specific advice for your condition please consult with your local health care professional.
Hello Doctor, I am a stent recipient. This information is amazingly informative.
Thank you for this video. I had 4 stents put in last week and definitely needed to this information.
Professor Barlis Is the most honest professional smartest cardiologist in the whole world. He doesn't try to scare people to become his patients like all other drs do. He just gives the facts and options may he live at least forever!
I just had a stint inserted in my LAD artery after a heart attack. My cardiologist told me I would need to be on medication for a year to prevent clots from blocking the stint. That was all the explanation required but I appreciate knowing the importance of the time element.
Late last year I had two stents placed: one in the diagonal and another in the circumflex artery. After 6 months the cardiologist said I could stop taking the clopidogrel. Afterwards, I stopped having multiple bruises. The bruises would appear out of nowhere for no apparent reason. I’m so glad I found your channel. My cardiologist is great, but so very busy. You have provided answers to questions I didn’t even know I should have asked. Thank you! Best wishes 🌸
do you mind sharing what your diet and symptoms was like before the first stent was placed?
My symptoms: angina, shortness of breath (daily) and racing heartbeat (occasionally)
ER visit had a high d-dimer lab result. No pulmonary embolism. But failed the nuclear cardiograph test which indicated areas that were not getting adequate blood flow.
Very helpful and informative. This was explained to me by the cardiologist at the hospital a little bit, but my brain was on overload at the time and just not taking it all in. so I'm very thankful for your videos!
Thank you for this valuable info, Dr. Barlis. I have a 3 yr old drug eluting stent, so I'm off the clopidogrel and am now taking an 81 mg aspirin daily. I greatly appreciate any information I can get. 👍
Glad to run upon your channel.
Many thanks to Dr. Barlis for creating these excellent recordings. They are the best and most informative source of information about stents and bypass surgery. Cardiologists should recommend these recordings to their patients so they will be well informed when choosing treatment options. The cardiologist and other medical staff that have treated me did good work but they only provided a small portion of the information contained in these recording.
you are amazing Prof. Barlis . Thank you for your passion and big heart.
Excellent, informative and educational. Many thanks.
Thank you Peter for this valuable information explaining the procedures involved in our treatments after a cardiac event.
Another quality explanation from the Prof
Thank you for the information, I had three stents put in about five years ago and no problems until a few months ago. Last checkup in January with an echocardiogram showed All was ok, then in April angina started, now awaiting an angiogram to find out what is going on. Seems strange to me that things changed so much in 4 to 5 months. I found your video helpful.
How are you now ?
Hi Dr Barlis, the clarity of your summary is second to none, and you have inspired me to follow your instruction details to the letter , your diction & proper emphasis is what makes your communication so great.
kindest Regards & wishes, Robert O' Rourke
Very informative and clear explantations of the many factors associated with clot formation in a stent.
The "covering" aspect was particularly interesting and explained why one needs to stay on the clot busting meds for at least a year.. Very helpful......Thanks!
I had 3 put in about 25 years ago, so far so good.
Is your first stent Still work?
Is your stent Still work?
@@fhgg7644I don't get any angina and can walk as far as my legs will take me. So I think they're OK.
O that's great 🎉
How did you maintain that did you had any habits like smoking
Well explained
Thank you for the great detailed info.
I have 5 stents...this is very informative. Thank you.
Excellent
Thank you
Feeling good after one month of my stenting in LAD . Probably no stent thrombosis will happen now . 😂
Thanks you for this useful information. I feel that most cases of stent thrombosis can be avoided b simoly following their doctor's recommended medications and ti go for regular follow up checkups.
As for me, I just had a stent installed into the :widow maker" and will follow my doctor's recommendations to the letter. But that is only the start. From here on, I am making life changes including avoiding bad nutrition, regular exercise and making sure I reach my goal weight. I am hoping after taking the blood thinners and other associated medicine, I would be able to slowly wean myself off them in time, but of course, only with my doctor's recommendation. I have never had a heart attack, nor stable or unstable angina, and am happy what I had was caught in time. :)
Thank you Dr !
Thank you.
Thank. You Doctor, I received one stent due to a heart attack in 2016, I have been wondering how one checks to see if everything is fine, I asked my heart Doc, he said its fine , don't worry about it.. After watching your video, I finally got the info. I needed.Thank you!
This is the key question but that imaging to see the stent healed is not routine. I am pretty sure it is not done typically on patients. If it requires catheterization, then this is invasive so it won't be down in the absence of serious symptoms. That is my frustration with cardiology science. Short of catheterization and the angiogram, you really cannot see what goes on there with indirect tests (EKG, stress tests, etc...)
He should never have told you to don’t worry about it. Change dr😏
I had a "bare metal stent" in 2009, 12 months later, TO THE DAY, I had the same pains as I originally had, and required restenting with a "drug aluting stent" inside the original stent.
Thanks, excellent explanation. Just had 2 stents, 3 weeks or so ago in addition to one 11 years ago. On aggressive meds before having a few more or a bypass for one artery.
do you mind sharing what your diet and symptoms was like before the first stent?
I thought you experts teached us students that a foreign object is attacked by our defence T cells and that this blankets the object. Why is this different from anywhere in the body.
If from this point serious diet and execrise is made, any help?
This happened to me. I experienced an in-stent thrombosis 6 1/2 years after placement for Unstable Angina. It led to a heart attack and then cardiac arrest needing 40 minutes of CPR (using a LUCAS device), cooling protocol, and a helicopter ride to a level 1 trauma center. I spent 2 days in a coma and a month in hospitals regaining the ability to walk. I experienced a host of complications, from lung problems due to intubation (collapse, edema, pneumonia), Acute Kidney Injury, Deep Vein Thrombosis, Ischemic Colitis, and Hypoxic Ischemic Encephalopathy.
It was almost comical how one thing led to another, with DVT requiring stronger blood thinners (Eliquis) in addition to Aspirin and Ticagrelor, which led to GI bleed from the Colitis, which led to H&H crash and cognitive decline, which led to transfusions. They had to put an IVC filter in to catch any clots from the DVT before stopping the Eliquis, forcing me to lay still for hours, which was almost impossible because of the sciatic pain caused by a gluteal tendon that had recent calcification, perhaps from coma immobility. It was bad enough that I couldn't walk, but I had gained 24 lbs of water weight in a couple days from the IV and AKI, but I lost it by the time I went home.
I still have some mild aphasia and some memory problems, including amnesia of the event. Everyone says that's probably for the best, since it was traumatic. Didn't stop me from developing PTSD later, according to psychologists.
I'm still not sure what happened. On my chart, the cath lab reports they aspirated the clot from the original stent (2.5 mm), which the described as "remarkably under-expanded", then tried to enlarge it with a balloon. That failed so they installed a larger, 4 mm stent inside it. I was confused how they could do that and my cardiologist (from a different hospital) said the older stent would have broken. Luckily, I didn't need Coronary Artery Bypass Graft as they weren't willing to do it because I had been down so long they thought I might be brain dead, making it pointless, and even told my mom she might have to make a hard decision the next day... but the EEG came back OK.
The very best of luck to you, and am hoping for the best.
You are a bloody warrior.
I felt really poorly this morning - I have firmly decided to never mention pain in public ever again.
were you on any antiplatelet at the time of in-stent thrombosis event? Aspirin or something else? I am asking because, in theory, after so many years that stent should have been covered in tissue and the risk of thrombus should be no greater at that site as in any other part of coronary artery. Is it possible that parts of the stent may not be covered in tissue 6 years after placement?
What an absolute nightmare...wow!
The idiots almost killed you. Stay away from drs when possible
Thank you for a very enlightening video!
At 65 I had my two bypass's stented 18 months ago after a heart attack EF at 40% .
My cardiologist just took me off Bralinta staying with low dose aspirin .
Still scared everyday ill die from some complication.
Any words of wisdom ?
Isn't laser angioplasty a better treatment than stents for coronary blockages or are stents still the preferred medical solution?
Good morning, doctor ! Thank you for your lecture. I am 63... and I will probably have to face a stent in my blood vessel. But is there any opportunity to treat the severe pain in my chest by using medications and maybe to trigger the process of autophagy?
Thank you so much Doctor. This information is very helpful for me being that I have 7 stents
Glad it was helpful!
7!? The physician's didn't discuss CABG aka bypass surgery with you or did you declined it and told them you'll take the stents?
Oh .. you beat me by 2!. I thought I had the record on here, but I have heard of people in double figures. 3 circumflex (for total occlusion), 1RCA and 1LAD (both to reduce smaller blockages) for me. I was 42 (now 49) , following an unexpected MI ; I smoked a bit until 30 but was also a gym goer, football player and occasional half marathon runner. Work stress (over working but didn’t know) and a genetic disposition did it for me. I’m running 5k’s again, (no competitive sport though), body weight and dumbbell resistance work too. Hope I can get 40 years out of them… just wish I could see how they are doing!.
@@dpaper7962 I had the choice but they advised that stents should work. They have so far….
Is a 48mm long stent okay in lad? 2.5mm in diameter.
This is an excellent education materials - thank you! Quick question. If the blood vessels got healed with tissues covering the stents within a few months than why would someone developed stent thrombosis later say after a year or more? Also how come, some get their cardiologists to stop the blood thinner med 6 months vs. 12 months and some would be taking them forever? Thank you
Sometimes the epithelial (tissue) growth can become too thick covering the stent.
How about “don’t put in stents”. Pharmaceuticals seem to be more effective.
is this gene based or the diet that would cause the overgrowth control of cell covering the stents? Thanks@@dr.emilschaffhausen4683
@@2cupojoe136 Not always true. Drug eluting stents have a proven track record, and drugs are not more effective in many cases.
The literature does not back your assertion. You might want to look at what John Mandrola has to say. Great name by the way!
I had 2 stents in my he art last year and didn't need it done According to my tests. Which I was not allowed to see results until after I got home.this was not exp k aimed to me. I was only told I'd die if I didn't. OR you might not make it back next time. I went to ER with a fast heart beat. So I've been miserable the past year. They ruined my life with the stents and over medication. Make sure you get an explanation of why you need a Stent in the first place. Demand to see your te sets. Every time ask a question they just got mad so I had to go to my primary for an explanation. He said why did they do this? I said you tell me here are my tests. I graded out at a 2 and he then told me that usually don't do stents until it tested a 3, 4,or maybe 5 depending on who is reading the tests.
I feel completely with you. I had the same experience and got 3 stents.
My partner has been kept on clodopel for twenty years now is that normal after having had two stents done. And he’s had no problems since
I have two stents placed in 2003 & 2004. In 2020 a pace maker was placed as my pluses was very low at 30. How do i check about my kidney functions? Thank you for your assistance.
Is your stent Still work
Problem you're in the ER and they say you need such and such procedure fone right away. They dont have time to explain the risks.
That happened to me .
Most of the time there in life or death situations bro
There busy
I just had a procedure done a week ago. Two stents inserted. I'm just sure what kind of stents or where they are located. I'm trying to educate myself as much as possible.
I had 2 Heart Stents in 2018 after a heart attack. I have been on ASS for the last couple of years. Can I stop taking blood thinners? I am not overweight and stopped smoking after my heart attack.
I had 2 stents placed in the iliac artery and both failed in a week. Crazy
Is it so hard/expensive to have the type of imaging you showed routine? Because it will help immensely the patient to actually visualize the healing and know whether the thrombosis risk is low or not and help him decide if he/she can de-escalate the stronger antiplatelets agents that have high bleeding risk.
you make an excellent point, this imaging technique, called optical coherence tomography (OCT) is used world-wide and is a very accurate way to look inside the heart artery and inside the stent. It offers a high resolution that can also tell the cardiologist why a stent may have clogged and failed.
@@HeartMatters Thanks for explaining. I might be wrong but, unfortunately, I don't think OCT is available and performed at all catheterization labs. Cause as far as I know OCT still requires catheterization which is invasive so it won't be performed without reasons just as a follow up check say one year after placing the stent. I guess my frustration with the stent protocol is that there is no less invasive/ less costly way to check the status of that stent unless or until something bad happens and that can be very bad indeed.
Can you ever totally get of your meds after stents been placed?
What about stents in the knee?
Thank you Doctor for such an informative upload. I have one stent since late 2020. And I am on Aspirin, Atorvastatin, Ramipril, and Bisoprolol. Could you please tell me if eating (and drinking) the following spices interact with these medication which I take everyday.
Clove Spice mixed in water, Turmeric ( about two table spoon a day), garlic, ginger, and cinnamon .
Consider taking Zetpil Curcumin suppository. It bypasses the stomach acids for maximum absorption. Curcumin is better than tumeric.
Same here
Is it possible to fix or replace clogged stent, or is bypass surgery the only way to fix this?
Great question! This can be repaired. I will cover this in the upcoming video on options including using another stent or a drug coated balloon.
@@HeartMatters - Thank you. Am looking forward to it! One other thing that would be interesting is to outline if there has been any innovation in this area in the last 10 or 15 years. Or are the stents and techniques still basically the same as they were 10-15 years ago?
❤
Stents aren't still made of metal are they?
I had a stent inserted last August. After the Covid fiasco, I lost a lot of faith in doctors, drug companies, etc. 17 people out of 23 in my family got Covid AFTER they got the vaccine. I don't like to take drugs. Clopiderole left huge black splotches on my arms and legs, and I quit taking it because I was concerned about possible bleeding in my brain. I quit the statin because of terrible diarrhea. I still take verapamil. I'd rather feel good and live for a shorter period of time, than suffer the bad side effects of the drugs. I'm in my 80's, ride an exercise bike every morning and do other exercise, and take supplements like garlic that help relax my veins, plus other supplements.
The Covid vaccine is not a full preventative. That’s not the point. It is very highly effective at reducing serious, life-threatening Covid and long Covid. It prevents health services being overwhelmed by patients needing critical care, which can result in serious consequences for the whole community.
There are many vaccines that work like this. For example, influenza vaccines may be imperfect but still save millions of lives.
The Covid vaccines saved uncountable millions of lives worldwide.
But you didn't respond to my question in your original comments in your first email..............
would dissolving stents prevent stent thrombosis?
I read somewhere about this. It is a very appealing concept. Stent is there a couple of months/years, allow the artery to heal and keeping it open and then slowly dissolve and leave you with a normal artery and no foreign bodies. Unfortunately, there is a possible new complication: as the stent disintegrate it may not do so in a smooth manner. Small pieces from it may break off, go through the blood circulation and then get stuck in vital narrower arteries (brain, lungs etc...) which may be fatal. So I don't believe this technology is there yet to be the preferred choice.
My dad is currently in ICU with multiple blockages in his arteries & he's on a machine helping him breathe. They Are talking about putting stents in, I'm scared he won't make it through the procedure. What is your opinion on this he has diabetes. He went in for an infection in his foot and turned into all this.
Don’t get scared, that’s the only way . I went through same thing. Go for it .
On some video I was watching they said drug coated stents keep the body from taking in but on another video was said just the oppisite.
Im confused I have watched one video saying its not the aim you say it is the aim for artery to end up covering the stent.
Heres the comment. Its on
#Nps Medicine Wise#
Stenting vs medication
The emergency room told me I had a heart attack a long time ago.
My cardiologist says I had a heart attack a long time ago.
They both said we cant know how long ago.
My Cardiologist said I’m fine and discontinued my heart meds and started me on stomach meds and sent me home wondering what step I need to take next.
I looked up my diagnosis and understand it.
But I disagree with the stability of my angina.
Any ideas anyone has, would be appreciated.
I have an appointment in 4 days to see my Primary MD.
@@rontimms8980 Is your angina stable or unstable? Unstable angina is when it occurs with little or no movement. Stable angina occurs with activity. I believe when a heart attack occurs, it causes a portion of the impacted location of the heart to go bad. This is not to be confused with heart failure when the heart is not able to keep up. As a suggestion, go get a CT scan, and most importantly, have it accompanied with the test that determines the blood flow to the heart
I am not in the medical field, but I gathered this information because I am also a heart patient. Of course, take it what I suggested with a grain of salt and see what your doctor suggests instead. The very best of luck to you, and am hoping all works out for the best.
I believe my angina is unstable.
My Cardiologist believes its stable.
Im Having mild chest pain a dozen times a day while at rest, sitting at my desk at work from home.
If I walk to far down my driveway I need to stop-paralyzed with severe chest pain pressure, center cheat shooting down arms and abdomen and burning and sometimes I have a panic attack, I begin with shortness of breath, shaking, shivering, freezing, then hot dripping/ sweating bullets and vomit and cry to Jesus for mercy.
Nitro has been my relief these past 2 weeks.
Update:
My Cardiologist just updated his notes today in my chart.
He shared my cardio catheter test results with another cardiologist, they both agreed my test results were complicated, and beyond their expertise, and recommended I search for another specialist.
I expect a call from his nurse with a referral for me to contact.
I’ve completely changed my daily routine to improve my physical and mental health.
But the anxiety and depression Im experiencing is something new for me.
Im wondering if I might have a bit of brain damage, now, due to some periodic minor confusion.
Im seeking help, and slowly getting it.
I am blessed, and appreciate the wake up call, God gave me.
Im happy to wake up in the morning and thankful I can stand on my feet and walk to the bathroom on my own.
@@rontimms8980 Not to confuse you further, the mild chest pains could be from a difference source. I also experience mild chest pains, however, my gastroenterologist diagnosed me that I experience this due to a heiteral hernia that I have in the stomach. So this not occurring from my heart. You might want to check into that also.
had this happen to me, 9 years after placement….turns out there was a small part of the stent, that had an edge, sticking out, that was blocking/grabbing things over the years, and it built up on that edgeuntil it said uncle and boom
Yes...that is why it would be nice to have some sort of imaging and actually see if the stent healed properly. Where you still on some antiplatelet agent 9 years after? ASpirin or something else?
@@Daniel_Maxin yes…it was a stent defect
Same here. The cardiologist has just put a stent inside the previous tent.
@@heywhotsgoinon8286 exactly…still good! lol hope you are too
Stent in proximal LAD .i am Diabetic too. Worries about what happens next.
Thats just great man its game over .Its fuckin game over man.What else can go wrong
It seem always your channel only against stents.. so can u discuss what is the remedy other than stents as u are obviously giving negative thoughts to other people who may really need it
Don’t forget your booster
I had a heart attack in January, so stents were fitted, one in back of my heart, one in main leg artery, due to my earlier lifestyle, smoking,drinking etc,I now get cramps in my legs, oh and dry gangrene in my toes, but that was a result of how bad my circulation was ,and an indication of what was going on,I'm 54 year old, have to change my lifestyle 😂