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Repeat Angioplasty Procedures

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Worried about stories of angioplasty failures and repeat procedures. Anyone have details?

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Current Postings on This Page (40):

• My mom had a heart attack in 1999 and underwent angioplasty to clear the artery blockages. Since then she has been under medication. But for the past 3 months she has gained lot of weight, and gets very tired when she walks. she went in for angiography yesterday and the doctor found tissue build up on the stent they had put in 1999 and one artery blocked 90%. So the doctor has once again done procedure called angioseal. Is there any way to prevent build of tissue or blockage of arteries? And is getting angio seal safe? Thank you all for the responses, I am in great need to know about this.
Ambi, New Jersey, USA, February 6, 2015

• Ketan - Your dad is what Dr. Paul Tierstein has called a "frequent flier." It may be his biology, genetics, etc. but he keeps blocking up. We don't think clopidogrel would be a factor because clopidogrel is an antiplatelet drug: it keeps blood from clotting inside the stent, called stent thrombosis. If your father had suffered a stent thrombosis, he would have had an acute episode, probably a heart attack. Restenosis is a different process: excess tissue growth inside the stent. This is why drug-eluting stents were developed. The drug given off by the stent keeps the tissue from growing too rapidly. We assume his stents were of this type. There are other issues. For example, the left main artery is more prone to restenosis. Diabetics also are at higher risk, although newer stents, specifically Medtronic's Resolute Integrity, have been approved for use in diabetics and show the same good results as in non-diabetics. Also, long stents, narrow arteries and incomplete stent expansion are all causes of restenosis. We recommend the use of IVUS to reduce instances of incomplete expansion. Also, make sure your father does everything possible to reduce his risk factors: proper diet, exercise, no smoking, and taking the proper medications.
Angioplasty.Org Staff, Angioplasty.Org, April 5, 2013

• My dad had undergone bypass in 1996. Two years back he started suffering again and our cardiologist advised us to do angioplasty. We had top put two stents to remove the blockages in his Left main artery. Within 3 months there was restenosis and we had to do balloon angioplasty to remove the blockage. After 8 months he again had to undergo angioplasty and we had to put 2 more stents . After 3 months there was again restenosis and we had to operate again and had to put a 4mm stent. After 3 months he again had a restenosis and we have now again completed another balloon angioplasty. Our cardio says that he may be resistant to clopidogrel and that may be a reason for the restenosis. Can anyone please help me out and advise how can I avoid another plasty or any other option available. My father's age is 67.
Ketan Wadke, Swadhaar Finserve Pvt Ltd, Mumbai, India, April 4, 2013

• My mom is having her third angioplasty in 11 months. Why so many and what are the alternatives? Does anyone know?
Shanny, infor, UK, September 21, 2011

• MLR from Saudi Arabia -- Angioplasty or stents, or even bypass surgery, are not "cures" for coronary artery disease (CAD). They are a way of relieving symptoms and managing the disease, which they have done in your case -- but the disease is a chronic one and can be challenging to keep in check. Combined with lifestyle changes (smoking cessation, diet, exercise) and modern medications, CAD can be slowed down or stopped. This is somewhat more difficult for diabetic patients, but work with your cardiologist to help prevent progression of the disease.
Angioplasty.Org Staff, Angioplasty.Org, March 22, 2011

• in oct 2009 i had heart attack and dr found blockage on my left artery and fixed stent gone thru angioplasty since that day i am taking all medication for high chol. and Plavix. unfortunately since last month i was having pain on my chest while walking after test found another block right artery and opened with stent. What precaution i should take care I am diabetic, TG high Chol. high Please advise.
MLR, NAFT, Jeddah, Saudi Arabia, March 22, 2011

• Ramba from Nepal -- relapse or, more specifically, restenosis or reblocking can be due to many factors, location of blockage (which artery, where), diameter of vessel, length of the stent, and the natural progression of disease, etc. It is important to reduce any risk factors under the control of the individual: taking the prescribed medications, eating a heart-healthy diet, exercise, weight reduction, if necessary, definitely(!!) stopping smoking. As for alcohol consumption, there are conflicting studies on this -- most seeming to say a moderate use of alcohol "may be" beneficial, but this of course depends totally on the individual and any other clinical issues he/she might have. 120ml (or 3 whiskey "shots") regularly seems more than "moderate" -- but that also depends on what you mean by "regularly". Alcohol may also interact with some of the meds you are taking. If you feel "not sound" we would suggest cutting the whiskey back for a week or so and seeing how you feel.
Angioplasty.Org Staff, Angioplasty.Org, October 31, 2010

• i did my two angioplasty within nine months time. what are the relapse factors? i take 120 ml whiskey regularly. is alcohol bad? i feel not sound.
ramba, Nepal, October 31, 2010

• Lynn -- 13 stents are a lot, although it depends on the stent lengths and how many of these 13 were used to reopen a stent that had reblocked (in-stent restenosis). One of the questions is determining when bypass surgery may be a better option -- and to make sure that the stents don't interfere with the cardiac surgeon's ability to do a bypass. Restenosis is a blockage that recurs at the same site of a previous blockage. But new blockages are symptoms of disease progression, which is why it is very important to adhere to lifestyle changes (stop smoking, better diet, exercise) and prescribed medications, especially statins to lower cholesterol.
Angioplasty.Org Staff, Angioplasty.Org, March 10, 2009

• I am not sure what topic this would fall. I have recently had my 13th stent. I keep having a problem with restenosis. I am just curious what is your opinion of these repeat procedures? I am getting afraid of hitting a wall as to what can be done if you have too many? Thank for info.
Lynn Jackson, Columbia, South Carolina, USA, March 2, 2009

• Rimmi - the important piece of information is what is causing the angina? Perhaps one of the stents has reclosed, or it's a new area. There are several non-invasive tests that might help diagnose this before commiting to an angiogram, possible angioplasty. This should be discussed with his cardiologist who can better judge your father's current state of health. To answer your question, many patients on these Forums have had multiple angioplasties (more than 3 for sure).
Angioplasty.Org Staff, Angioplasty.Org, May 15, 2008

• My father 78 had bypass in 1987, first angiplasty in 1997, another angioplasty (4 stents) in 2005. Now he is having angina again. Can he go in for third angioplasty? He weighs 55kg.
Rimmi, Delhi, India, May 11, 2008

• elenD -- the risks of a second procedure are pretty much the same as for the first. You should discuss your concerns with his cardiologist and ask these questions, because the doctor has your father's records and is a better judge of risk than anyone. It sounds like your father "restenosed" -- the blockage returned. You should ask if he/she is planning on putting in a stent and, if so, whether a bare-metal or drug-eluting type.
Angioplasty.Org Staff, Angioplasty.Org, August 1, 2007

• my father had a bypass 15 years ago. this december 2006 had his first angioplasty and had ~100% blockage (circumflex) to one artery that the doctor didn't not put stent. now after the thallium treatment we discover that the results of the first angioplasty were not good and my father will enter again in for a second angioplasty. My father is 77 years old. how dangerous is the second operation. he has following a healthy diet years now and his blood, his pressure, his weight and other results are good. BUT he use to be very anxious...
elenD, Athens, Greece, August 1, 2007

• M. Tiwari et al -- certainly, one of the top questions after having a successful angioplasty is what is the next step? Assuming, all has gone well and the access site has healed, you should not have many restrictions regarding the angioplasty itself. What has happened is that a mechanical "fix" has been made -- that is, the artery has been opened. But angioplasty (or bypass surgery or medications alone) do not cure the underlying disease. What patients need most to do is to reduce their risk factors for coronary artery disease: lower cholesterol, blood pressure, increase exercise, lose weight (possibly) amd definitely stop smoking. Some of these goals can be achieved by the patient; others may require the use of medications, such as statins or BP medications. Of course, you should ask this question of your cardiologist because every person has their own clinical situation and level of health, so what may be right for one person, may not be for another. Talk to your cardiologist, work out a plan with goals and then work toward achieving them.
Angioplasty.Org Staff, Angioplasty.Org, May 28, 2007

• Having recently had angioplasty (on March 19, 2007 in Escorts New Delhi) with 3 stents: 2 in LAD and 1 in RCA. After angioplasty I am feeling well. My lipid profile is normal and TMT normal, BP normal, no diabetic. Please suggest me regarding what precaution and sex. (my age 41 yrs)
P.K.Tiwari, ICAR Institute, Jodhpur(Rajasthan) India, May 27, 2007

• Re 2002 post regarding metal allergy & stents. Since mfgs warn against inserting metal stents into sensitive or allergic persons, and metal causes strong itch and rash on the skin does anyone know what nickel is doing to our insides while we're busy scratching the outside? If nickel causes problems to skin (and lungs if inhaled) how do we know it's safe to put into our hearts or arteries? Any scientists out there?
Carole, Atlanta area, Georgia, USA, July 21, 2006

• i underwent angioplasty and three stents were put in main and other two arteries on 9.5.2006. i am feeling fine, no chest pain etc. What long term measures can be taken for future and if reversal of artery disease is possible?
Gajinder, India, May 20, 2006

• i had 2 stents put in. 7months later they both re blocked, then i had 2 more stents put in, but they are the coated stents. still geting pains(angina)
john, liverpool, UK, December 13, 2005

• my sister had stent operation on friday 19th august 2005 and it was unsuccessful. is there anyone out there who knows about this. she was told she has to go on drugs as she has 90% blockage of the smaller artery to the heart.
thomas ryan, galway, ireland, August 20, 2005

• Two years ago I had 3 stents put in one artery. I also have 1 artery with a 70% blockage that is being treated with medicine. I have lost about 20 lbs. on a low fat diet. I walk and jog on a treadmill everyday. I feel great. My heart was not damaged by my heart attack.
Linda Cotham, Bell Buckle, TN, 14 Sep 2003

• John, My name is john Griffiths, san jose, california. I went in 4 weeks ago to have a stent inserted. but once into the angiogram they determined that I had over 90% blockages in around 10 seperate areas. So I was put into surgery for an immediate quadruple bipass. that has now been 3 weeks and am pretty well on the mend. I hope you stent is still holding well. In the past few years they have developed chemicals to eliminate the platlet build up. Best to you. John Griffiths
john griffiths, san jose, ca, usa, 08 Oct 2003

• Dee, as stated in our disclaimer, we don't dispense medical advice and any concerns should be discussed with your doctor. That being said, we can act as a librarian, pointing you to resources. There have been concerns about allergies to nickel and other metals in coronary stents, as well as in other devices. One stent company in Germany (Phytis) even touts non-allergenic biocompatible stents. To our knowledge, there haven't been any reports of significant allergic reactions to nickel in stents, which is not to say that there haven't been any. One topic that is discussed is whether nickel and other ions that are generated by stainless-steel stents have a role in "in-stent restenosis" by increasing the inflammatory response, especially in sensitive patients. This recently was discussed as the topic of a presentation by Dr. T. Lefevre of Massy, France at the prestigious EuroPCR meeting in Paris in May. Hope this is of some help. We invite others to join in this discussion.
Editor, Angioplasty.Org, August 2, 2002

• I am having angioplasty with stent next week. I have always had a nickel allergy therefore I have never been able to wear jewelry. My doc says the stents are made of stainless steel. I've read that stainless steel has nickel in it. I am worried about having an allergic reaction to the stent. My cardio/vascular doc laughs. Has this happened? Please respond.
Dee, Dallas/Forth Worth, Texas, USA, 1 Aug 2002
• I am a 76 year old male , who had angioplasty done near my heart the end of April 1993. Been on medications and a diet, lost 38 lb in 11 months, still on special diet.Have been diabetic since 1985. Have had NO pain or discomfort since just before the procedure, after, feeling great. QUESTION: How long since 1993 might I expect my angioplasty to last? Some rumor-mongers say about 6-7 years.
David Owen, retired, Taunton, Massachusetts, USA, 17 Apr 2001

• You mention allergy to nickel. My dentist fixed my fillings with nickel . I have a crown with part nickel. What symptoms would I have? Present time aching all over etc. Help me if you can! Thanks.
Bonnie, unemployed at present due to illness, North Carolina, USA, 23 Jan 2001

• I have had a by-pass operation in 1993 and since then three angioplasties. My problem seems to be hereditary high cholesterol levels. I have now gone complete vegetarian and take 40 mg zocor per day. I have heard about Dr Ornish's book "programme of reversal of heart disease" and is very interested to get hold of it. Exclusive Bookstore in Durban South Africa informed me that it is not available. Could somebody help?
Neels Jansen, Pensioner, Durban, Kwazulu Natal, South Africa, 3 Jun 2000
• I recently had angioplasty with a stent. We are planning a trip to Florida in June. A friend told me you have to have a card to go through the detectors at the airports. Has anyone ever heard of this? Should this be a concern?
Nick Kent, Ahmeek, Michigan, USA, 30 Apr 2000
• After heart attack in Jan 97. was re-admitted to Winchester hosp. uk. 4wks later re-admitted with crusuendo angina. 3rd,March 1997. Attended Southampton uni.hosp. uk. had stent in one artery others were ok. heart had not been damaged. Within four wks. had started attending [rehab. at specialist Dr.Hugh Bethal at Alton.] also on Dr. Dean Ornish's diet (not strictly to book but well below 20 grams fat Two yrs later angina gone Ecg.s good and general fitness above average for age 56yrs.
Jim, Alton Rehab, Four Marks, Hampshire, United Kingdom, 14 Apr 2000
• I had angioplasty with stents for three blockages in two arteries carried out 15.11.1999 - so far with marvellous results. I am trying to find out about exercise programmes having just joined a health club. I am 52 years of age and weigh 80kilos.This is the first exercise I have done for over 25 years. So far, I have a half hour workout as follows:
Recumbent Cycle - 5mins @ level 4
Stairmaster - 8mins 'steady pace' @ level 4
Cross-trainer - 10mins Fatburn programme (with 2mins reverse)
Treadmill - 7mins Random programme @ 6km/p/h with incline @ level 4
The programme is continuous and my heart rate peaks @ 116 but at the end of the workout is down to 96. I am still taking 50mg Atenolol and 5mg Amlodipine. What should my heart rate be? Should I be doing more intensive or longer workouts or using different / more equipment? I follow this up with a brief session in the swimming pool, sauna, steam room and hot-tub. I no longer have any angina symptons. Any tips or advice would be welcomed.
Austin Whiteside, Satisfied Patient from Broad Green Hospital, Liverpool, UK, January 25, 2000
• My husband age 46 had double angioplasty on Mother's Day 1999 one a balloon the other a stent. well tomorrow Dec 17th he is having a stent in the balloon artery as it did not stay open. He is totally optimistic about the surgery. He had no heart damage from the first heart attack. He had one in June 1998 but the doctor convinced him it was stress and put him on antidepressants and off work . What he really had was two blocked arteries. His doctor is great now and the surgery should be simple. He expects to be back to work next week. Last time it was a week also. There is no reason ever to fear angioplasty
June, Eugene, Oregon, USA, December 16, 1999
• My husband was 57 when he had his first angioplasty and stent placement. He went back every 3 months from Jan-Sept when they finally bypassed the area. This year at age 59 another artery started blocking in January. Again angio and stents every 3 months with all other arteries clear. It just keeps restenosing until it's bypassed. Unfortunately, for him, he's one of the few who do this. He does excellent on his diet but could do more exercise. His lipid levels are good. We can't help but wonder when the craziness will end.
Laura, Kansas, USA, October 25, 1999

• John, I am an Exercise Physiologist and would suggest you consult a qualified exercise specialist in regards to your exercise program. It is far too brief and intense and as a result may place you at higher risk rather than lower. You are on the right track, keep at it.
Allison, Sydney, AUSTRALIA, July 28, 1998

• John, just came across your post on stents. I am a 49-year-old male who had balloon angioplasty with a stent in the LAD artery in July of 96 (the same night as the TWA flight 800 crash). This was done at NYU Medical Center in Manhattan. I'm going on two years and I feel great. I was about 15 lbs. overweight and still am. I do a little more exercise regimen then you do, but email me and we will talk.
Barry Brown, New York, USA, April 26, 1998

• Dean Ornish's diet doesn't have to be ascetic either. A cookbook in which he has compiled gourmet recipes from some of the great chefs in the San Francisco Bay Area is "Eat More, Weigh Less". It's out in paperback and is available at your bookstore or through an online bookstore, such as Amazon.Com, for under $6 (US)! We use it and it has an terrific Angel Food Cake recipe, which also give you great aerobic exercise beating the egg whites.
Burt Cohen, Angioplasty.Org, March 26, 1998

• Hi John. Dean is the doctor, Mike (that's me) is the patient. You can find out more about Dr. Ornish's program in his book, "Dr. Dean Ornish's Program For Reversal Of Heart Disease Without Drugs Or Surgery". I'd be surprised if it's not available in the U.K. Diet is but one aspect of the program. Moderate exercise, meditation and other stress management techniques, and group support are the others.
Fat-wise, Dr. Ornish recommends not adding additional fats to food, but using whole foods such as whole grains to provide the small amount of fat needed for health. The target is 10% calories from fat for those of us with coronary artery disease. The best thing about the diet is its simplicity: No animal products except nonfat dairy and egg whites. No other restrictions except no nuts or seeds, no high-fat vegetables like olives and avocados, and limit sugar. Eat as much as you like. Certain cooking techniques have to be relearned, but lots of satisfying food can be made within these guidelines.
I'm no health professional, but I can't help but comment on your exercise regimen. I think it may be too intense and too brief. Ornish recommends a brisk walk for a minimum of a half-hour per day. I don't think you can make an even trade between intensity and duration. Good luck.
Mike Drayton, patient, USA, March 25, 1998

• It is possible you have an allergy to chrome or nickel. Stainless Steel stents set these heavy metals free. Our stent (surface is diamond) prevents the release of chrome and nickel.
Norbert Sass, Phytis L.D.A., GERMANY, March 6, 1998

• Thanks to Jorgen and Dean for answering my question. Dean - you mention Dr. Ornish - I have heard of this in a few different places - how can I get hold of a copy of his program?
John Griffiths, patient, UK, February 9, 1998

• In early October, I had angioplasty with stents in 3 arteries, 80% blockage in one and 70% blockage in the other two. The early results were quite good with all angina gone and stress echo looking excellent. I just went cross-country skiing at over 7000 ft elevation with no problems. Since I am 46, my primary concern is how to prevent progression of the underlying coronary artery disease. I have decided that the best bet is a very low fat vegetarian diet a la Dr. Dean Ornish. I am also incorporating the exercise, meditation and group support facets of his program as much as possible. My serum cholesterol went from 251 to 147 in the first two months, aided by Lovastatin (20 mg/day). There was also a big improvement in the LDL/HDL ratio and a reduction in triglycerides. I only wish I could see into my coronary arteries!
Mike Drayton, patient, USA, January 26, 1998

• Good Luck John. 70% didn't return, Just watch yourself, I'm one of the 30%. I have since May '95 clocked up 14 trips to cath lab, six of them balloon jobs. I'm carrying 6 stents, and I'm proably soon due for another trip, I'm going to my cardiologist next month. Who knows, it may take 5 or more years before you get into trouble again, so why worry unnecessarily.
Jψrgen Andersen, patient, AUSTRALIA, January 25, 1998

posted by John Griffiths, patient, UK, January 18, 1998
Having recently had angioplasty with stent for a 95% blockage I am worried by the stories of angioplasty failures. I am told that in as many as 30% of cases the first angioplasty is not the last. Anybody have any details?

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