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Indications and counter-indications for cardiac stents

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Health care industry that seems to be driven by the quantity of procedures, rather than the quality of patient care. And you may get a stent not because you need it but because the cardiologist profit from performing the angioplasty. Hospital are also involved in this scam. At least a dozen of US hospitals were under investigation and half a dozen of cardiologists were iether disciplined or jailed. It is actually very difficult to prove this particular type of malpractice so often trial ends with settlement.  Around 300K unnecessary stent are inserted annually in the USA. This is a big business and you should ne aware that they want money, and do not actually care much about your health.

Angioplasty for  patients with stable coronary artery disease reduces chest pain, but does not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy

Diabetis is a strong counter-indication and essentially doubles the risk of serious complications.

If you have expressed atherosclerotic changes of  the arteries with the deposition of calcium, have a history of formation of blood clots, or your blood vessels prone to spasm, angioplasty is not recommended.

While this is generally a pretty safe procedure, complications during angioplasty and stenting include but are not limited to the following:

  1. The development of an allergic reaction to the contrast die,
  2. Damage to the artery wall. Manipulating arteries with a stent or any other sort of medical procedure can lead to the walls of the blood vessel becoming injured or damaged. The innermost layer of coronary arteries, known as the endothelium, is particularly susceptible to this sort of damage; the result can be the formation of scar tissue in the area of the stent, and this too can lead to the artery re-narrowing in a process known as restenosis. Treating Restenosis can involve an additional stenting procedure, though in severe cases where a stented artery recloses it may be necessary to have a patient undergo a coronary artery bypass to remedy the condition.
  3. Bleeding at the puncture spot of the artery
  4. Studies show that about 3 percent of patients experience serious complications.  In this case a new deposits form at the same place which again start to constrict the blood flow in the artery for which angioplasty was performed. In stent restenosis after bare metal and drug-eluting stent implantation more frequently is observed in patients with high fasting-insulin levels and IR.
  5. Blood clots. Antiplatelet therapy is prescribed for patients who have coronary artery disease (CAD), carotid artery disease or peripheral artery disease (PAD) and to patients who have had a heart attack or stroke. It is critically important for patients who have received a stent. that includes taking aspirin and a second antiplatelet medication, such as Plavix, Effient, or Brilinta, is called dual antiplatelet therapy (DAPT). If you are a patient who is about to undergo a medical procedure with a physician other than the cardiologist who prescribed DAPT for you, be sure to talk with both doctors.
  6. Impaired renal function. 
  7. During angioplasty, the blood flow problems may occur in other arteries remote from the one at which surgery is performed.

Around 3% of patients has complications after the surgery. If you have diabetes or kidney disease, you belong to the group with the high risk for complications and your risk approximately doubles to 6%.

What Questions Should I Ask My Healthcare Provider About Stents?

Heart Stents Tools for Treating Blocked Blood Vessels

  1. What are my alternatives? Could I be treated with medicines instead of a stent?
  2. What follow-up is necessary after the procedure? What do I need to do?
  3. What medicines will I be taking?
  4. Can you help me with my concerns about medicines (side effects, financial cost, etc.)?
  5. What lifestyle changes should I be making?
  6. Would I benefit from being referred to cardiac rehabilitation?

You might add

  1. What is the justification
  2. What are risks:  Studies show that about 3 percent of patients experience serious complications.
  3. Why stents are better then medications?
  4. What are indications: “Stenting in stable angina is open to debate in some circumstances as to whether it reduces mortality but every study done shows it is effective in relieving symptoms,” he said.
  5. What is mortality for diabetics. In stent restenosis after bare metal and drug-eluting stent implantation more frequently is observed in patients with high fasting-insulin levels and IR. Stenting only occurs as part of an angioplasty procedure and therefore carries for such pacients additional risks. Risks specific to a stent include that scar tissue or a blood clot may form within a stent, or very rarely an allergic reaction may occur.
  6. What are side effects. restenosis Stent replacement.
  7. What drags you need to take for life. Antiplatelet therapy is prescribed for patients who have coronary artery disease (CAD), carotid artery disease or peripheral artery disease (PAD) and to patients who have had a heart attack or stroke. It is critically important for patients who have received a stent.

    Taking aspirin and a second antiplatelet medication, such as Plavix, Effient, or Brilinta, is called dual antiplatelet therapy (DAPT). If you are a patient who is about to undergo a medical procedure with a physician other than the cardiologist who prescribed DAPT for you, be sure to talk with both doctors.

  8. What is the useful life of the stent
  9. health care industry that seems to be driven by the quantity of procedures, rather than the quality of patient care.
  10. Why check x-ray have shown (copies)

    What overnight observation have shown (summary)

    What blood analysis had shown (copies)

 


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[Oct 10, 2016] What Are the Most Common Stent Side Effects (with pictures)

Stents are small tubes that are placed inside arteries or ducts to keep them open once they have become compromised. There are a variety of stents that are designed for different procedures and applications. Some of the procedures include the use of coronary, esophageal, ureteral and biliary stents. The majority of these are made from stainless steel mesh and plastic; however, there are other stents that act as grafts and these are made from a special fabric. There are a number of common stent side effects that can occur, and these could include blood clotting, calcification, bleeding and pain.

There are two types of stents that are typically used: bare mesh stents and stents that have been coated with a medication. These are referred to as drug-eluting stents and serve to prevent arteries from reclosing. These devices are generally effective and save lives; however, there are instances when patients can experience negative outcomes. Clinical trials involving wire mesh stents into the brain arteries discovered that the stents caused strokes in patients. Stent side effects when performing procedures for coronary artery blockage can sometimes cause chest pain, swelling of the arms or legs, and bleeding from the insertion site at the groin.

... ... ...

Patients experiencing stent side effects from devices coated with medication sometimes present with blood clots, and in some cases allergic reactions to the stent itself. This is usually treated with drugs; however, scarring at the site of the stent can be a common side effect. Drug-eluting stents can also cause gastrointestinal bleeding, flu-like symptoms, chest pain and strokes.

Studies have shown that these symptoms and effects can also occur in bare mesh stents yet seem to be more pronounced in the medicated devices.

Although not as common, other stent side effects can include lung disease and even cancer.

[Oct 08, 2016] Indications for stents

Yahoo Answers

A few days ago I answered the same question about Coronary Artery Bypass Graft (CABG) surgery. The indications are essentially the same.

Stents are used to open blockages in a tubule structure. They are most commonly known for their use in the coronary arteries but may be used in other areas as well. In the arteries they are used to spread the artery open where a blockage or narrowing has occurred. Some patients are served well by stents but others require CABG. The decision is normally made by the cardiologist. Stenting or CABG is determined by the number of blockages, the severity and their location(s). Normally, you go in for a catheterization.

If blockages are found and stents are needed, it will normally be done at that time. If CABG is required, they will complete the catheterization then arrangements will be made to perform the CABG.

To see the question on CABG and my and others answers click this link:

http://answers.yahoo.com/question/index;...

For information on stents click this link:

http://www.nhlbi.nih.gov/health/dci/Dise...

For information on CABG click this link:

http://www.nhlbi.nih.gov/health/dci/Dise...

There are a ton of other information sources. If you would like more just contact me by going to my profile. There you can click on "Email Terry S" or click the link below.

http://answers.yahoo.com/my/message_do?kid=AA10902014

Terry


gangadharan nair


The main purpose of a stent is to counteract significant decreases in vessel or duct diameter by acutely propping open the conduit by a mechanical scaffold or stent. Stents are often used to alleviate diminished blood flow to organs and extremities beyond an obstruction in order to maintain an adequate delivery of oxygenated blood. Although the most common use of stents is in coronary arteries, they are widely used in other natural body conduits, such as central and peripheral arteries and veins, bile ducts, esophagus, colon, trachea or large bronchi, ureters, and urethra.(Wikipedia)

Most of the time, stents are used to treat conditions that result when arteries become narrow or blocked. The devices are also used to unblock and keep open other tube-shaped structures in the body, including the ureters (the tubes that drain urine from the kidneys to the bladder) and bronchi (the small windpipes in the lungs).
Stents are commonly used to treat coronary heart disease (CHD). If you have coronary artery disease that does not cause symptoms, you can be treated with either medicine or angioplasty with stenting. Recent studies show that medicine and angioplasty with stenting have equal benefits. Angioplasty with stenting does not help you live longer, but it can reduce angina or other symptoms of coronary artery disease.

Angioplasty with stenting, however, can be a life-saving procedure if you are having a heart attack

Other reasons to use stents include:

* Keeping open a blocked or damage ureter
* Treatment of aneurysms, including thoracic aortic aneurysms
* Unblocking a large artery, such as the carotid artery (carotid endarterectomy)
* To keep bile flowing in blocked bile ducts (biliary stricture)
* Helping you breathe if you have a blockage in the airways

Dr Frank

Stents are inserted routinely now at angioplasty to improve the chances of keeping the vessel open. They would be used for any lesion where the vessel is wide enough to take them. Since the routine use of better anti platelet drugs, clopidogrel, the risk that the stent itself will clot has been reduced dramatically.

Source(s):
GP for more years than I care to remember
Dr Frank · 9 years ago

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