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Forum Name: Cardiology Treatment Modalities

Question: Is 7 stents too many?


 jrw1 - Tue Apr 21, 2009 7:32 am

My family and I are distraught with anguish at the moment - My Brother is just 49yrs old and was admitted to Hospital - he had an a mild heart attack, he was kept in on a heart monitor and given some intrevenious drug to think the blood along with warfarin (injection in the tummy)... They were unable to give him an angiogram due to waiting list being full but they kept him in. He had several minor attacks each day until on Friday (day 5 of his stay) when the consultant was present he had a more severe attack the consultant sent him urgently in an ambulance to Bristol Royal Infirmary where they gave him the angiogram and angioplasty (is that correct?) they inserted 2 stents and the following day they sent him back to GWH. He has not improved and had other attacks whereby they took him to the procedure theatre in Swindon and inserted more stents??He has had 3 procedures and I think we are up to 5 or 6 stents now? is this usual? I cant find the information I am looking for but it seems to me to be extreme. My brother was sent home a day after another mild heart attack he was sent home and told to stay in bed for a couple of days . He has been home for 3 weeks but is tired and not well he is also having pain almost daily. He was told to call an ambulance if pain got bad - today he had another bad attack and as I write this is in the ambulance going back to the GWH procedure room; not sure what they are doing ? But it sounds like they are going to insert another stent??(stent 7!!) It seems to me that the stents can not be working, we are so worried my mother and sisters are in turmoil we lost our father to a heart attack which is making this all much more worrying. Is there an alternative procedure maybe a bypass and if so why do you think they are not doing this?
 John Kenyon, CNA - Fri Apr 24, 2009 9:50 pm

User avatar Hello --

While seven stents is not unheard of, and theoretically is a reasonable approach, by the time that many have been used (or considered) it usually is time to just go in and do a cornonary artery bypass (however many are needed, usually a minimum of three). What's happening most likely is that your brother has extensive plaque buildup in his arteries (several at least) and when a stent opens up one ruptured plaque another segment collapses just downstream, requiring another stent, which is pushed throught he previous one then opened up. There is a theoretical limit to how much of this can be done, and at 49 your brother already has significant cornonary artery disease, so my guess would be there is a bypass surgery in his near future. I personally feel this is often the more useful approach, as it lasts longer and places less hardware in the way where it can actually attract more plaque sometimes. When multiple stents are failing to stem the problem, CABG makes perfect sense even though it's more complicated in terms of the patient's comfort and has a much longer recovery time. It's basically getting all new plumbing, and while there is so much apparent disease, it would benefit your brother for some time, even if he later requires additional stents placed inside those bypass grafts. I know that may sound odd, but it's done quite often, and since it's taken him 49 years to reach this point in the disease process, it may well take that long to get there again, which would be a pretty long time.

I hope this helps answer your questions, and please follow up with us here as needed and by all means update us on your brother's situation when you know more. Good luck to you and especially to him.
 jrw1 - Sat Apr 25, 2009 2:01 am

Dr Kenynon your reply has answered many questions thank you so much for taking the time to answer our concerns. I will let you know the progress. Thanks again

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