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How Long Will A Stent Last?

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"Stent life" is a frequent concern for patients who write to us wondering how long a stent will last, and how to prolong the value of a stent.

A metal stent actually is permanent; your body's endothelial cells grow over the metal implant, incorporating the device into the arterial wall for the rest of your life. However, just because the stent device is there doesn't mean it will permanently remain effective in treating your disease.  In a minority of cases (less than 10% of cases with 2nd generation Drug-Eluting Stents), a stent can become reblocked, called "in-stent restenosis."  If this happens and your stented artery closes up, your doctor might re-open the blocked stent with a balloon, or even place another stent inside the blocked stent.  In a small number of cases, the stent itself may become fractured or may pull away from the artery wall which may be a cause of restenosis or possibly stent thrombosis, blood clotting inside the stent.

The best way to keep a stent from reblocking or the disease from progressing is to reduce as many risk factors as possible. That means lifestyle changes, including a healthy diet and exercise program, quitting smoking, taking the medical therapy and drugs your doctor prescribes, and scheduling an annual check-up visit with your cardiologist to stay on top of disease management. If you can slow or halt your Coronary Artery Disease from progressing, you'll increase your quality of life and prolong your stent's effectiveness. A stent is not a cure for your overall condition, but it can be a lifelong help to you in your fight for good health. Read more about drug-eluting stents here.

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Current Postings on This Page (162):

• Roy in India - First of all, congratulations on changing you lifestyle and modifiable risk factors (smoking, diet, exercise, etc.). This is not an easy thing to do, but many who do this feel better after their procedures than they did before. We don't think that having a stent should interfere with sailing, but any question like this is really one for your cardiologist - it's not really possible to offer blanket advice because each patient is an individual with different clinical status. For more information on what some heart patients have been able to do after stenting, check out our Forum Topic, "Exercise, Sport, Physical Activity After Stent."
Angioplasty.Org Staff, Angioplasty.Org, June 23, 2013

• I am 56 y, and had chest pain diagnosed as angina, the cardiac spl inserted a stent, and one month later I am fine. I walk 1 hour in the morning and again in the evening, plus have stopped using the car for short distance, is the workout excessive, I feel tired and exhausted in the legs? Lifestyle changes, quit smoking, reduced oil in food. And stopped red meat and alcohol. I have diabetes mellitus controlled with medicines fasting 104-110 sugar. Next Q, I am a sailor, is the stent a bar for returning to sailing again, or is it possible after a recovery time, is so then what period of time. Thanks in advance for your advice.
Roy India, Calcutta, India, June 23, 2013

• Saya berumur 60 tahun menjalani 6 stent 3 tahun yang lalu. Makan obat lapitor dan plavik di tahun pertama dan kini cardiprin dan sivastatin. Berkebun di hujung minggu dan jaga pemakanan. Stress macam biasa semasa bekerja. Kini bersara. Hidup kini sihat. Harap seterusnya begitu. Tapi saya di datangi penyakit lainnya iaitu penyakit saraf yang tidak ada kena mengena dengan jantung ataupun obatnya. Menjalani pembedahan laminoplasty 3 bulan yang lalu. Masih dalan rawatan dan sakitnya lebih pedih dari sakit jantung. [Our staff's rough translation from the Malay: I am 60 years of age, had 6 stents placed 3 years ago. Took Lipitor and Plavix for the the first year and now cardiprin and simvastatin. Gardening on the weekend and taking care. Common kinds of stress at work. Now retired. Life is now healthy. Hope so. But I have other diseases, neurological disease. Laminoplasty operation three months ago. Still in treatment and more painful than the pain from the heart attack.]
Jafar, Kuala Lumpur, Malaysia, June 23, 2013

• C. Kapoor in India -- As we've written above and in other places, angioplasty and stenting is only a mechanical solution to a biological problem -- the problem being coronary artery disease. Although, in your mother's case, it seems to have been a successful solution for 8 years now, not much different than the outcomes for bypass surgery. Impossible for us to say whether or not it's a problem in the stented artery, or it's the progression of her disease, or something else entirely, but you and she should certainly see her cardiologist for a diagnosis of her chest pain and shortness of breath, since those are certainly symptoms.

And Ramin in Afghanistan -- not exactly sure what you mean, but if you are asking whether you can have non-cardiac surgery performed after stenting, the answer depends on how long after the stenting you are talking about. Patients with drug-eluting stents need to stay on dual antiplatelet therapy (DAPT) which is aspirin and clopidogrel (or a similar drug) for a year (6 months in Europe and other areas). This is to prevent a blood clot inside the stent (called "stent thrombosis"), which can lead to a heart attack and be fatal. However, these DAPT drugs are blood thinners and can complicate surgery by causing increased bleeding problems. Most surgeons will ask you to stop taking the DAPT before the surgery. But if it is too soon after stenting, you run the risk of a heart attack. For more discussion, see our Forum Topic on "Plavix (Clopidogrel) and Surgery."
Angioplasty.Org Staff, Angioplasty.Org, May 23, 2013

• after stent process (2 stents in blockage of 80% & 90%) can the patient have any other body parts surgery or not?
Ramin, Herat, Afghanistan, May 20, 2013

• My mother got 2 MIs in 2005 and was implanted with 2 taxus stents in April 2005. She is 77 yrs of age and for past 3 months is feeling very weak, is breathless most times and has suddenly very high BP or low BP. She occasionally gets pain in her chest. could there be a problem with her stents?
C. Kapoor, Delhi, India, May 19, 2013

• Worried Wife in Tulsa -- Perhaps a joint appointment with your husband's cardiologist would be a good idea. First of all to rule out any problems, but also to find out why your husband is missing his meds. Perhaps he is having some side effects like fatigue. Perhaps an adjustment in dosage is in order if that's the case. Maybe your husband needs to understand exactly what each med is doing for him. Staying compliant with medical therapy is very important.
Angioplasty.Org Staff, Angioplasty.Org, May 15, 2013

• My husband needed a stent due to 90% blockage in the main artery of his heart in 2010. The cardiologist told him the day he was released from the hospital that he would need his medication for the remainder of his life. Point blank, you don't take the meds, you will die. My husband is missing meds several times a week now. I check his blood pressure often and it is always at a good level. However, he is dragging by the end of the day. I'm fear he is going to have a heart attack or stroke. Are these conscious concerns or worries on my part?
worried wife, Tulsa, Oklahoma, USA, May 15, 2013

• Adventurer's Heart -- Perhaps ask your cardiologist about trekking in cold climates. It's not so much that the stent will cause a problem, but that you want to make sure you're physically in good condition to do so. But stent patients who are physically fit do amazing things: IronMan Triathalons, mountain-climbing, etc. Check out our topic on Exercise, Sport, Physical Activity After Stent.
Angioplasty.Org Staff, Angioplasty.Org, May 10, 2013

• Hello, I'm 36 and had twice mild attacks while swimming and once while at sleep midnight. High cholesterol for 2 years unattended medically. Now I'm doing great with a primary stent placed in an artery which was 70 percent blocked. Being an adventure person I cant stop trekking. Though its been 8 months now from my angioplasty, how will my stent behave in chilled climatic conditions in mountains while trekking. I still continue to swim and I feel normal and full of stamina.
adventurer's heart, Artist, Neral, India, May 6, 2013

• Pete in Canada -- As for a "shelf life" on stents, read the introduction (above).

KP in India, you should ask your cardiologist why he feels you will need bypass, if there is no problem currently. Left main blockages can be treated successfully with stents, although in complex disease, specifically in diabetics, bypass may be best (see FREEDOM Trial). Clopivas is recommended for 6-12 months after stenting, but your cardiologist may feel longer is better. As for whether or not your stents are "working", a nuclear stress test may show whether perfusion (delivery of oxygen via the blood to the heart muscle) is sufficient.
Angioplasty.Org Staff, Angioplasty.Org, April 20, 2013

• I had a heart attack in 2003, had a stent put in. Have got out of state medical insurance at a reasonable price since then, now for some reason the insurance company's are asking a ridiculous price as 10 years are up. Is there a shelf life? I have had no health issues since 2003. I have my annual stress test at the hospital and always pass.
Pete, London, Ontario, Canada, April 19, 2013

• Male 45 years old, had PTCA+STENT (3.5x38mm PROMUS ELEMENT to LMCA & 2.5x16MM PROMUS ELEMENT to PDA) one year back. Under regular medication from last one year with CLOPIVAS, STATINS, PROLOMET, TAB PAN. After one year how one can know whether these stents are working fine?? When can I stop these medicines? Some shoulder pain, left arm pain, joints pain do come & go. Otherwise heart seems to be ok. But my cardiologist seems to be worried about the future outcome since LMCA needs BYPASS rather than STENTS. Is he right in his perception?? Pls. advice. After one year is it required to go ANGIOGRAM OR TMT again??
KP, Karnataka, India, April 11, 2013

• Hi this is sudhanshu....i am from star health insurance,dear all as you know that no other insurance company in india is covering CABG and PTCA patient (who have been undergone surgery of CABG and PTCA) in their policy, but we have a unique policy for these patients and we are covering all heart surgeries and medical management if needed again, star health will cover all these complications after 90 days of policy issuance so plz contact me on this number 08604526063 .....sudhanshu tripathi sales manager star health and allied insurance company limited.
star health and allied insurance company ltd, star health and allied insurance company ltd, kanpur ,up , India, April 11, 2013

• Hi, thanks for the response. I have no Angina and run approx 20 miles per week. The problem is that the regulations say that no reversible myocardial ischaemia is allowed. When I do a nuclear perfusion test the result is a small amount that the cardiologist states is insignificant. This is not acceptable as it does not meet the regs. The cardiologist is of the opinion that the ischaemia is caused by a small diagonal branch being blocked by the insertion of a couple of stents into the LAD. They have tried to push a wire through and did not succeed. I' am wondering if I have any other options.
TMG, U.K, April 6, 2013

• Someone [below] asked how long they needed Plavix after getting a stent. My Doc said 1 year is the normal recommendation but he recommends to his patients 2 years to be extra sure everything heals properly (stent becomes part of artery without more blockage)Anyway - my two cents. I too worry about my stent (in a stent). First time I didn't realize how important Plavix is. After second one, I took the Plavix for the entire two years. So Far - so good.
Jason, Ellington, Connecticut, USA, March 31, 2013

• Ajay -- Your query is timely. A large study of 1,892 STEMI (heart attack) patients dealing with an aspect of this issue was just presented at the American College of Cardiology annual meeting. It was called STREAM. It was published simultaneously in the New England Journal of Medicine. You can read it online; it's titled "Fibrinolysis or Primary PCI in ST-Segment Elevation Myocardial Infarction." The study looked at heart attack patients presenting at a hospital where emergency (primary) PCI was not available and who could not be transferred to a PCI-capable hospital to receive angioplasty within one hour. These patients were randomized to receive thrombolytic therapy and then transferred for PCI, or transferred directly for PCI, but outside the one hour window. The result was that there was no significant difference in these two groups. However, that's not to say that angiography should then not be done in the thrombolytic group. A heart attack would indicate some degree of coronary artery disease, so we would think that an angiogram would give some helpful information, especially if there is doubt as to whether an angioplasty should be done. That, of course, is up to his cardiologist. We cannot give advice on that issue. However, it would seem that this now can be done on a non-emergency basis with time to discuss what option would be the best therapy.
Angioplasty.Org Staff, Angioplasty.Org, March 31, 2013

• Hi, My father who is 68 years old had his first heart attack a week ago and was treated within 6 hours with thrombolytic therapy and is doing well without any complications. Doctors have different opinions about him having Angiography/and or Angioplasty (if needed). The split is mainly around 1)is it now indicated? and 2). When to have?. should this be done as soon as possible or after few weeks. He doesn't have any risk factors or other existing diseases and has been prescribed few medications for heart attack patients. Is anyone aware of the general advice or guidelines around the above issues?
Ajay, Lucknow, India, March 16, 2013

• TMG in the UK -- The stent doesn't have a "wall", but is made up of a lattice-work of struts. Trying to force an opening in these struts more than what is already there runs the risk of stent fracture, dissection of the arterial wall, etc. -- all of which would be much more serious problems. We're not clear about one thing: if, as you wrote in your February 17 post, your cardiologist says that the amount of ischemia in the diagonal is clinically irrelevant, and can put this down in writing, then why wouldn't you pass your medical? Additionally, nuclear stress tests are helpful certainly, but they are known to have a relatively large range of false positives. Are you experiencing angina or any symptoms at all?

To RB in Pennsylvania -- Definitely ask your cardiologist about your Lipitor dose. There are benefits to statins beyond just the lowering of cholesterol, but you should have this conversation. Especially if you are experiencing any side effects of the drug. As for Plavix and aspirin, guidelines recommend one year post-drug-eluting stent to keep the blood from clotting inside the stent. Depending on each patient's clinical profile, your cardiologist may recommended Plavix for a longer period, because again, Plavix has benefits beyond keeping the stent from clotting. One question is whether the artery was 100% blocked by obstructive plaque, or more likely, by thrombus (clotted blood) that formed. As for the other blockages, they may or may not be "significant", i.e. causing ischemia. If they are not significant, guidelines state that they are best managed through diet, exercise, and medications. Again, each individual patient has a different clinical profile, so your cardiologist is really in the best position to explain these issues to you -- a better understanding of the cause of your heart attack and the state of your coronary arteries will help you recover better and move forward.
Angioplasty.Org Staff, Angioplasty.Org, February 27, 2013

• Hi, it is a small diagonal. My issue is that for my job I need a medical and part of the criteria is that I cannot have any ischaemia. I wonder if it is either possible to get out of stent jail by cutting the stent wall and then angioplasty to the small diagonal or to completely block it off?
TMG, United Kingdom, February 23, 2013

• I am a retired women who had a heart attack and stent placed in my right coronary artery five weeks ago. i had 100 percent blockage and still have other blockages. I was in excellent health weight 123 lbs cholesterol was 142 total ate well and have exercised since the 1970's .never got short of breath. Dr. has me on 80 mgs of Lipitor,and Plavix and small doses of aspirin. will i have to stay on this strong dose of Lipitor even though i don't have high cholesterol? have not seen surgeon since stent placed and was in intensive care. will go back in another week. also how long will i have to be on Plavix? how will they know if the other blockage is cleared up? no reason can be given for heart attack and all the blockage.
RB, Williamsport, Pennsylvania, USA, February 22, 2013

• Moha -- Read our article for more about Abbott's BVS (Bioabsorbable Vascular Scaffold). The restenosis for this device were in the low single digits in the initial studies which is comparable to other stents. As for stent life, this "stent" is designed to disappear completely after around three years, leaving the artery in a more natural state than permanent stents. It is a new device that has not yet been approved for use in the U.S., although it received the CE Mark (Europe) two years ago.
Angioplasty.Org Staff, Angioplasty.Org, February 21, 2013

• I've had a PTCA on my LAD on 18 Feb 2013 using BVS from Abbott. The vessel had 75% blockage. There are not any perceptible symptoms after four days except a feel of exertion if I do some walking. I am on Brilinta with Aspirin. I have borderline DM but under control with drugs. I wish to know how permanent the PTCA is and what are the chances of restenosis
Moha, India, February 21, 2013

• Hi, it is a small diagonal. My issue is that for my job I need a medical and part of the criteria is that I cannot have any ischaemia. I wonder if it is either possible to get out of stent jail by cutting the stent wall and then angioplasty to the small diagonal or to completely block it off?
TMG, United Kingdom, February 21, 2013

• TMG in UK -- Not sure which side branch is blocked. This is a complicated issue and can't really be deciphered without your records, angiography, etc. If the ischemia is minimal, then you are not putting your heart at risk. In cases where this "side branch" is a major one, a technique known as bifurcation stenting could have been used. But it sounds like that was not the case. If you are experiencing symptoms of angina, it is possible that may wane over time, or that your cardiologist can prescribe an anti-anginal medication, such as ranolazine.
Angioplasty.Org Staff, Angioplasty.Org, February 17, 2013

• Hi, I'm 46 and have 6 stents in the LAD. The issue being that an original was placed across a side branch. This re-stenosed and a drug eluting stent was fitted. Now when I do a nuclear test I show ischaemia in the area of the side branch. An attempt to push through the wall of the stent to the side branch had failed. The doc's say that the amount of ischaemia is clinically irrelevant. Do I have any other options on how to open this area, PCI or surgery? Will this side branch eventually become blocked totally anyway and no more ischaemia? If this is the case could I get the area blocked off?
TMG, United Kingdom, February 17, 2013

• Muralidharan in India and Rod in North Carolina -- Read our response to PB in Michigan (Feb 2, 2013). Smoking is strongly implicated in coronary artery disease. Muraidharan, we're not sure if you are saying you stopped smoking but, if so, good. We would also refer you to our topic on In-Stent Restenosis, which is the technical term for what you had. Our introduction at the top of this page states that a stent itself is not a cure. As Andreas Gruentzig, the inventor of coronary angioplasty, used to say, it's only a mechanical solution to a biological problem. And patients need to work with their doctors to lower the risk factors contributing to that biological problem. Rod, definitely talk to your doctor about a smoking cessation program; he/she can also prescribe a patch or some other aid to help you, possibly some help with your anxiety as well. It is NOT easy to stop a habit like smoking and it's harder to do it alone. Get help from everyone you can. You WILL start to feel much better.
Angioplasty.Org Staff, Angioplasty.Org, Feb 12, 2013

• Hi, I am 42year old, i was stented in the month of august 2012 in my main artery, 90%. It was a drug eluting stent, now on 7thfeb 2013, my doctor says the stent failed to work, and i was replaced with a new stent in the same place, 95% block. My habits early was 15years yoga, 3, years gym, till 10day before the first stent was put, non vegetarian, smoker, drinking. Could you please advise me on the second.
Muralidharan, Bangalore, India, February 12, 2013

• I had quadruple bypass in March 2012. 2 graphs failed and I had another heart attack in June.. Was this from continued smoking? Had 2 stints [stents] put in ( the new drug releasing kind). Am back at work, but I continue to smoke. Can that cause my stints [stents] to fail?? I'm having a lot of trouble quitting smokes, and I'm feeling anxiety and little pains in my heart area...
Rod from NC, Fayetteville, North Carolina, USA, February 11, 2013

• PB in Michigan -- Smoking two packs a day is a major risk factor for coronary artery disease (not to mention emphysema, cancer and numerous other health problems). A drug-eluting stent is a way to relieve a specific blockage, but it doesn't "cure" what is a chronic disease. The most important thing your husband can do to reduce his risk of heart attack is to stop smoking. This is, of course, not easy, because smoking is an addiction and he will need all the support he can get. Perhaps his physician can help prescribe a nicotine patch, etc. or recommend a smoking cessation program.
Angioplasty.Org Staff, Angioplasty.Org, February 2, 2013

• My husband had a stent in his LAD in 07 cause primary was smoking. He continues to smoke 2 packs a day but is very active. How long on average do these drug eluting stents last?
PB, St. Johns, Michigan, USA, February 2, 2013

• PRC?
Angioplasty.Org Staff, Angioplasty.Org, February 1, 2013

• How long do the stents last after a successful PRC ?
Bhattacharjee, Retired, Kolkata, West Bengal, India, January 21, 2013

• Was having a massive heart attack. Had emergency heart surgery within 4 hours of getting to hospital. Widow maker artery 100 blocked. Had a bypass for that. Found a bleb on lung which was pressing on heart. Bleb was caused from smoking. Home within 7 days. Feelin good.
Lucky to be here, Kentucky, USA, January 20, 2013

• I had a single stent put in in 1999 after a mild heart attack. I take aspirin, Lipitor as prescribed by my doctor. I also take fish oil and anti oxidants and keep a close watch on my diet. I drink the odd glass of wine, try to walk min. 30 minutes a day and i also try to control my stress levels. I see a cardiologist once a year and have a stress test. I do not have any angina . I am very grateful for the wonderful medical care i get in Ottawa , i am now 64 years and still working as a self employed designer, i hope this will encourage those who might be facing similar situations. Thanks for this forum.
FC, Ottawa, Ontario, Canada, January 17, 2013

• Yunus in Kenya - reduce any risk factors under your control (weight, diet, smoking, exercise, and taking the proper medications). And try not to lose hope. Depression after heart attack is a common event, but these days with modern technology, devices, medications, heart attacks do not mean the end -- they are often a new beginning for many.

And Swami1988 in India, open heart bypass surgery (CABG) vs. angioplasty (PCI) is the big question in the treatment of coronary artery disease and the subject of many trials. When there are questions like this, many recommend having a heart surgeon (one who does bypass) and an interventional cardiologist (who does stents and angioplasty) confer together on the best approach.
Angioplasty.Org Staff, Angioplasty.Org, January 15, 2013

• hi, I am Yunus, age 48 year. I am heart attack patient and i got attack on the day of 17 Nov. 2012 weight 80kgs I am scared of my life and thinking about my 3 children they are school. Please advice me what is next step should i move and I've loose hope of my life.
Yunus, Nairobi, Kenya, January 10, 2013

• MY mom is 55 years old...she gets three 4 blockages in her 3 main arteries and on in side artery. Dr. suggested for CABG..but because she is very weak. Dr again suggested to implant 3 stents in her all three main arteries. and one side artery should be left behind as according to Dr it will not create problem.. kindly suggests..pls
Swami1988, India, January 4, 2013

• Just a note - Neither we nor any website cannot give medical advice on whether travel is safe, what a patient's risk percentage is, etc. because every patient is an individual with a specific clinical situation. We'd urge you to ask your cardiologist these types of questions. That being said, people with stents, etc. do all types of activity, including marathon running. But you need to ask your cardiologist specifically about what you can and cannot do safely.
Angioplasty.Org Staff, Angioplasty.Org, January 3, 2013

• I am 81 years old and had an angioplasty 10 1/2 years ago. I had an angiogram 2 years ago with very good results having 30%. I am refused coverage because of the time and I am sure age but I wonder if having an Echo stress test with good results is worth the risk of travelling without insurance for heart. I am fine in every other respect. Thanks.
Josie, Ontario, Canada, January 3, 2013

• My father had a heart attack a little more than a year ago. He lives in India and the cardiologist told him he had one 100% blockage and inserted a medicated stent. He was 67 and now he he is 68. He does not smoke, but he is over weight and does very little exercise. He diets but not a strict dieter. He cannot let go of some his food habits and gets angry if I suggest that he has to moderate his diet and exercise. I live in USA and I would like him to visit me. He will get a checkup prior to his trip, but I am worried about another heart attack. I would appreciate any advise or chances of another heart attack. He takes a blood pressure, Plavix and has mild diabetes (blood glucose of 104).
Kumar, New Jersey, USA, December 30, 2012

• Luiz from South Africa -- see our Forum Topic on In-Stent Restenosis. Placing a stent inside of another stent is one of the standard treatments for this problem, although technically it is "off-label."

And Gina from New Jersey, we are most sorry to read your unfortunate story -- we have gotten posts in various topics from patients (mostly women) whose doctors used the phrase "all in your head" to dismiss what turned out to be a real problem. The vast majority of cardiologists will not do this. We'd suggest in cases where this is said, but you don't feel it's correct, that you seek a second opinion. Check out our blog, "The Activated Patient."
Angioplasty.Org Staff, Angioplasty.Org, December 29, 2012

• Hi- I am 56 years old. two weeks ago my stent which was inserted 13 years ago blocked, a second stent has now been inserted within the old one (quite a bit longer 30mm). My question - is there any danger having a stent inserted within a stent ?
Luiz From SA, Sasolburg, Free State, South Africa, December 20, 2012

• Hello Dr., I am a 34 y/o woman and horribly I suffered a Major Heart Attack in my RCA w/ a 90% blockage ten days after finding out I was pregnant w/ my now Miracle Child! I def had a family history w/ my fathers side as far as heart was concerned, High blood pressure, High LDL cholesterol, and several Bypass surgeries. I really thought that I lived a pretty well balanced life weighing in at 115 pounds and was obviously thrown for a loop like the treating Dr.'s as well! My question is in your expertise how could something like this happen? I had been experiencing left arm discomfort (throbbing like sensation) and exhausted. I went to a Dr. several times through emergency b/c I was convinced I was having a heart problems. Kicker was the Dr.'s said it was all in my head and nothing was wrong w/ me! November 9, 2011 I almost lost my life and my unborn child's life b/c of Dr. negligence in not believing in me! I suffered a massive heart attack and still to this day have 2 more blockages, I want the readers to please listen to my short version of a long story and please listen to your intuition on your own body!! Dr.'s are not god!!
Gina, New Jersey, USA, December 14, 2012

• I had an angiogram done last week and had a reaction to the Plavix and aspirin I was given so the doctor decided against doing a stent for my right coronary artery which has a 90% blockage. Anyone else have this problem? I have to wait another week to see the cardiologist to find out what the next step in my treatment will be. I'm afraid to do anything for fear of having a heart attack.
Skennedy909, Ontario, California, USA, December 13, 2012

• Ajay in India - You should consult your cardiologist regarding a specific exercise and diet regimen -- this can vary from patient to patient, depending on your clinical situation, state of health, muscle tone, etc. And you should check in from time to time with a medical professional to monitor how you are doing. The meds you are taking are critical to someone with drug-eluting stents. Clopidogrel and aspirin keep the blood from clotting inside the stent. These need to be taken at least one year, until the stent is "healed" and the risk of blood clotting is reduced. To read more about the extent of exercise you may be capable of, read our Forum Topic on Exercise After Stenting.
Angioplasty.Org Staff, Angioplasty.Org, November 26, 2012

• Hi, I had to go through angioplasty on Dec. 2011 with 3 stents, 2 medicated in RCA having 90% AND 70% blockage and 1 stent non medicated. My weight is 65kg, height 5 feet 4 inch and age 39 yrs. My BP is normal. I take aspirin, clopidogrel and seloram 25/2.5.I feel sometime pain in nearby area of heart i.e. front and backside. I WANT TO MINIMIZE MEDICINE AND LIVE 41-50 YRS MORE. PLEASE GUIDE FOR PROPER DIET AND EXERCISE. THANKS----AJAY,
CSS, DMI, FARIDABAD, INDIA, November 23, 2012

• James in California -- Ubiquinol (a.k.a. Co-Q10) and Omega 3 have been looked at as being heart-helpful for some time now, although there is not a lot of clinical trial results proving their worth. Co-Q10 is thought to counter some of the muscle weakness effects of statins. Omega 3 has been thought to be helpful as well, but newer more powerful prescription medications may make the added effect of this drugs somewhat marginal. As always, we recommend that you consult your cardiologist about all drugs you are taking, prescription as well as over-the-counter medications and supplements.
Angioplasty.Org Staff, Angioplasty.Org, November 23, 2012

• I am 52 years old male, and just had 4 stents placed (3 at RCA & 1 at LAD) 2 weeks ago in Taiwan. I am taking all the medicines (including Plavix, Bokey, Syntrend, Silvinol, Mevalotin Protect, and Fadin) that Doctor gave me daily and feeling OK. Question: Can I take Ubiquinol & Omega-3 daily? Will these 2 supplemenst help my heart?
James Lin, State Employee, Cypress, California, USA, November 22, 2012

• Concerned Wife in Michigan -- Smoking in general has all types of negative health effects, from lung problems to heart disease. You didn't mention whether your husband has gotten a stent, but if he has and is having significant pains, he should see his cardiologist -- preferably the one who placed the stent. As for marijuana, we can't give any type of opinion on that, especially since it is not legal in most places. But in places where medical marijuana is dispensed, one can find many forms in which it can be ingested: brownies, cookies, etc.
Angioplasty.Org Staff, Angioplasty.Org, November 7, 2012

• My husband 55yr old he thinks as long as he is not smoking tobacco it is o.k. for him to smoke marijuana he says it relaxes him and takes away the pain, however he takes a lot of aspirin due to the pain he is experience in his left arm and lower back. Will smoking of any sort be detrimental to his health. Very Concerned Wife.
Concerned Wife, Michigan, USA, November 6, 2012

• Husbands in Arkansas -- You didn't mention if your husband has had a stent placed (the topic of this Forum). This post should be made in our Forum Topic on Problems After Bypass Surgery. He clearly has had previous bypass graft surgery and from your report, one of his vein grafts is now closed. Did he also have a LIMA (Left internal mammary artery) graft? This type of bypass lasts longer than vein grafts. What are his symptoms? Have you consulted an interventional cardiologist?
Angioplasty.Org Staff, Angioplasty.Org, November 5, 2012

• my husbands heart cath results; Severe native vessel coronary artery disease involving left coronary artery system with patent vein graft left anterior descending no percutaneous coronary intervention. vein graft to obtuse marginal is also patent with good run-off. vein graft to the diagonal is occluded / What does this mean?? Said cannot do surgery/ What to do now?????????
Husbands Heart Cath results, Hot Springs, Arkansas, USA, November 2, 2012

• RBW in Canada -- Hard to think that stents that have been implanted for 4 or more years could move from a cough. They'd be pretty embedded in the arterial wall at this point. Are you having any symptoms that would indicate a problem?
Angioplasty.Org Staff, Angioplasty.Org, October 24, 2012

• I am a 6 stent recipient 1 in 2001, 2 in 2008 (1 original non medical then redone. ) 1 separate and 2 very small for length ones in 2010 May & Aug. All in the LAD. I have a severe cough from a sinus cold and have had to use nitro spray more in the last 2 days than in the last 2 months. ... Is it possible one of the Stents may have been dislodged due to the heavy cough.. I will be 67 shortly.
RBW, Gananoque, Ontario, Canada, October 20, 2012

• baf6591 from Australia -- We have moved your post to our topic, Flying After Catheterization or Angioplasty.
Angioplasty.Org Staff, Angioplasty.Org, October 14, 2012

• My 47 year old partner just had to have an angioplasty due to shortness of breath the angioplasty they found the left main was widely patent, left anterior descending had severe stenosis, left circumflex PDA moderate disease, right coronary artery widely patent...what i can see on the notes it says PCI to LAD with drug eluting stent, he has been discharged on Atorvastatin, Clopidogrel and Aspirin, plus Ramipril. As we were due to travel from Australia to USA in a few weeks we have found we cant get cover for travel insurance, my husband is prepared to take the chance that nothing untoward will occur as the stent has improved his situation and he has medication. My concern is what if the stents collapse or cause a blood clot. Maybe you can give me some indication of the odds of this occurring and if it did occur would it be instantly dangerous or would we have enough time to return home back to Australia. If its something we would have to pay for in USA what sort of fees would we be looking at
baf6591, Perth, Australia, October 14, 2012

• D. Patel in Africa -- You had a number of risk factors for coronary artery disease (CAD): (1) smoking; (2) family history. You mention your weight, but without knowing your height, can't say if that is a factor. Then there are the measures of cholesterol, HDL vs. LDL, blood pressure, trigylcerides, etc. Certainly your stopping smoking is a MAJOR step forward. That is one of the greatest risk factors for CAD. Family history is also a strong indicator, but there's nothing that can be changed about that -- except to lower all the other risk factors as much as possible. Most recommendations allow moderate use of alcohol -- but your weight gain of 6 kg (13 lb) is concerning, so we'd suggest discussing a more heart-healthy diet with your cardiologist or doctor. By the way, weight gain after stopping smoking in relatively common.

And Worried in Iowa -- your husband's fatigue my be due to any number of things: damage to the heart muscle when he had his heart attack, the side effects of new medications, lack of exercise, etc. We suggest making an appointment with his cardiologist where you both go and discuss this.
Angioplasty.Org Staff, Angioplasty.Org, October 14, 2012

• I am 48 years young vegetarian Indian male, inserted 2 drug eluting stents one year back, stopped smoking completely but continuing with 2 double pegs of Whiskey or 2 glasses of red wine daily, 2 years back father died with an heart attack, weight was 74 kg before stenting and now 80 kg, feel like eating sweet daily and I am not diabetic. Is eating sweets daily OK and is it a reason of my weight gain? What should I check frequently ? Thanks in advance.
D. Patel, Africa, October 13, 2012

• My husband had a heart attack at 55. He had 2 stents first procedure went back in for stress test. He was hospitalized again and a balloon procedure and 1 more stent was done. He is faithful to taking his meds however now I am noticing symptoms of him such as he tires easily again. He has energy in the morning but is tired and falls asleep while I am talking to him. He says he feels fine but agrees he tires easily. No chest pains. He is a hard worker but he was good with energy for a while but now that has changed.
Worried in Iowa, Hancock County, Iowa, USA, October 10, 2012

• JB in Maryland -- If your bypass grafts are open and working, you should be fine. Why you had these heart attacks post-stenting is a complicated issue and you should discuss this with your cardiologist so you understand. Sometimes stents close up (restenosis) and bypass surgery works better. Sometimes it's the reverse (as in President Clinton's case). The blockage in your leg is actually the same disease -- atherosclerosis -- that caused your heart blockages. While there's no cure yet, reducing risk factors is the best way to keep this in check: diet, exercise, no smoking, staying compliant with prescribed meds, keeping both blood pressure and cholesterol in check.
Angioplasty.Org Staff, Angioplasty.Org, October 1, 2012

• I am 49 yrs old. Had a major heart attack 3 years ago, 2 stents put in and a month later had another heart attack, and then another while in the hospital. I had double bypass. I was just told that I have a Blockage in my right leg, that will need to be stented. They did a CT scan 2 wks ago and he said my stents had closed up but, bypass working. What does all this mean. It sounds scarey to me, and I worry. Will I have another heart attack like the first one? That's when I had the stents put in. Please advise.
JB, Manchester, Maryland, USA, September 30, 2012

• Wachucha et al -- When you get a stent, you get (sort of) a new lease on health. The stent opens up a blockage and keeps it open, allowing greater blood flow to your heart. But this does not cure your disease. It is, as the inventor of coronary angioplasty Dr. Andreas Gruentzig always used to say, "a mechanical solution to a biological problem." Once you have received a stent, you need to do whatever you can to lower your risk factors: stop smoking, if you do; change to a healthier diet; loose weight; adopt a more active lifestyle; stay compliant with your prescribed medications. Get regular checkups, but it's easy to start over-testing. If you are feeling good, symptoms gone, and generally healthy -- there's no need for regular stress tests or CT scans, etc. In fact current guidelines specifically recommend against this type of over-testing.
Angioplasty.Org Staff, Angioplasty.Org, September 29, 2012

• Hi, I'm a 56 years old male. I had angioplasty over two years ago with two stents. I've been on medication and have significantly changed my lifestyle. Could you please guide me as to how I can ensure that my CAD is under control. What tests and with what frequency should I take to ensure that I'm on a right track. Best regards.
Wachucha, Riyadh, Saudi Arabia, September 29, 2012

FATIMA, student, Pakistan, September 22, 2012

• I am 58 years old got stent angioplasty this week, suffering from type 2 diabetes for the last two years taking Metformin 500 mg twice a day. I want to know that implanting stent is for a long time or for a short time, please tell me. Thanks.
TARIQ, London, England, September 17, 2012

• I was 42 when i had symptoms of angina and subsequent troponin leak , i was found to have 3 vessel disease and i opted for stents - a sum total of 8 stents with 4 in the RCA , 3 in LCX and one in LAD , its been nearly 4 and half years since my stent procedures , i have been doing fortunately well with no cardiac complaints , I'm active and continue to monitor my diet , so for now all is good , the more you read about stents and the outcome , the less certain you become as to the long term prognosis My advice to all is that take your meds , modify your life style a little , do not smoke , exercise and leave the rest for god - No one can be certain as to what your long term prognosis is - but you have to try and put your best foot forward -- and yes drink up a glass or two of wine
nerd, Pennsylvania, USA, September 12, 2012

• Multiple answers to questions from the past month -- first, Ashley in Calgary -- annual nuclear stress tests are not recommended to "check" on stents; these tests are expensive and also expose the patient to radiation. And they are not as accurate as an angiogram which is, of course, invasive. Are you having any symptoms? Since your stents are from a decade ago, they have long since been covered over by endothelial tissue and, since you don't seem to be having any symptoms, you should assume they are fine.

Harsha in India -- Also, are you having any symptoms that are concerning you? If not, try not to worry constantly about your disease. It sounds like you are doing the right things, like Satish from Pune reports. However, depression is most definitely a known "side-effect" of heart disease -- and it's one that is seldom identified or treated by cardiologists. Perhaps getting some therapeutic counseling for the depression might help you.

And Satish, as noted above, it sounds like you're doing everything you need to do. Stents don't "wear out", but they may get blocked. Yours, however, are 7 years old, and if they were going to get reblocked they already would have.

Finally Oppegans in Georgia -- sweating is not a normal or common after-effect of stenting. You might want to consult with your cardiologist, and also read our Forum Topic on "Not Feeling Well After Stenting."
Angioplasty.Org Staff, Angioplasty.Org, September 10, 2012

• What is the life of stent after angioplasty and till how many years this stent lives good in human body?????
A TO Z , India, August 31, 2012

• I am 70 and had a stent procedure a couple of months ago. My problem is constant sweating and no energy. Is that common?
pppegans, Atlanta, Georgia, USA, August 31, 2012

• I am 56 years old and got my medicated stent in march 2005. I am taking medicines and morning walk regularly. My eating habits are good and I do not smoke and consume alcohol. I am living retired life and do not have much problems. I get medical examines every 6 months. I would like to know the life of my medicated stent. Also any major precautions I need to take. Please advise me. thanks.
Satish G, Pune, India, August 29, 2012

• I am 36 I had stent in 2006 Nov. in US and i have quit smoking and drink occasionally am a social drinker.. Reg food habits i eat not so healthy food,not so bad food either. On a recent check on my cholesterol everything was under control and HDL was good and LDL was below the line.. No sugar traces. I take Plavix and aspirin for the past 6 years. also Olmigest 20 mg for lowering BP. used to have rosavus 20 mg i stopped taking it as its a lowering cholesterol i feel so down when i take that. i feel so feared all time that something might me ..that's causing me depression..pls advice what to do on this..
harsha, India, August 27, 2012

• My two stents are 12 and 10 years old. I am 69 years old. I am working out, keeping weight down and on cocktails of heart medicines for stable angina. I had thallium test last June 2012 (2-4% risk of subsequent ischemic cardiac arrest). Now diagnosed with early stage of Parkinson Disease. Should I be concerned about replacing vintage of stents. Is a new thallium test adequate or do I need to have angiogram to insure that stents are fine?
Ashley, A concerned patient, Calgary, Alberta, Canada, August 22, 2012

• Conservative J in Illinois -- You shoud read over our Forum Topic on Plavix, Effient, Aspirin and Stents. The standard recommendation has always been one year of dual antiplatelet therapy (DAPT -- aspirin plus either Plavix, Effient or Brilinta) even though some recent studies have shown 6 months or even 3 months may be okay -- this varies from patient to patient and also has a lot to do with the artery being stented, etc. A bypass graft is more prone to clotting and restenosis, so a longer regimen of DAPT might be called for. But this is something you need to discuss with your cardiologist.
Angioplasty.Org Staff, Angioplasty.Org, August 20, 2012

• On Feb. 24, 2012 I had two drug-eluting stents inserted in one 90% blocked bypass graft. The stents are, one XIENCE V, 4.0 mm x 23, lot 0102841, S76652, ref 1009549-23 -OWT and one XIENCE V, 4.0mm x 18mm, lot 1012541, S66081, ref 1009549-18 - OW T. On my last visit to my cardiologist we had jointly agreed that I should take one 10mg Effient every day for 6 months plus the 81mg aspirin that I was already taking every day. Last week I found out that I need some dental work done and the dentist suggested that I should ask my cardiologist if I could have this work done while on Effient or should I wait until I would stop to take Effient on Aug. 23. 2012. Of course I could not talk to the doctor, so I told the nurse to relay my questions to the doctor and call me back with his answers to my questions. The nurse called today and told that I'll have to stay on Effient an additional 6 months because recent research indicates that 6 months may not be enough. I am not too pleased with ingesting this blood thinner for an additional 6 months, beside that Effient is a very expensive drug. Should I take Effient for an additional 6 months and what is that going to do for me.
Conservative J, Arlington Heights, Illinois, USA, August 13, 2012

• Denny101 in Washington -- read up on Drug-Eluting Stents in our Stent Center.
Angioplasty.Org Staff, Angioplasty.Org, August 12, 2012

• I had an echo cardiogram done, my cardiologist wants an angiogram done, as says if there is a blockage he wants to implant the drug-eluting stent to prevent clotting. I heard that these can be dangerous, as after healing eventually it has a possibility of one of the wires from the stent can pierce the artery causing clotting and heart attack, is this true? I am scheduled to have the procedure on Sept. 6th.
denny101, Federal Way, Washington, USA, August 10, 2012

• Medical Industry in India -- try looking at our Forum Topic on Plavix, Effient, Aspirin and Stents.
Angioplasty.Org Staff, Angioplasty.Org, August 9, 2012

• after stent angioplasty how long do need to take medicine
Medical industry, New Delhi, India, August 8, 2012

• Was it a cranial stent? Or a carotid stent? In any case, you might want to check out our interview with Dr. Hopkins of the Toshiba Stroke Center in Buffalo, NY.
Angioplasty.Org Staff, Angioplasty.Org, August 8, 2012

• In 2006, I had several small TIAs followed by a stroke. It was determined that the stroke was caused by the collapse of a portion of my left carotid artery. A cranial stent was inserted in the artery (near my left ear) to restore blood flow. I think the stent was titanium. My doctor prescribed Plavix and Coumadin for 6 months. I returned home to the U.S. and was seen by a local stroke specialist who thought everything had been handled well by my physicians in Manila. I now take one 81 mg aspirin daily. In 2008 I had a cranial ultrasound that showed good blood flow thru the stent. I do not currently have health insurance and have not had a check up or follow up tests since 2008. My question – You say stents last forever, but can become blocked. Is there anything I can do to keep it from becoming blocked? Are there any tests I should have to determine if all is well? If yes, what tests and how often? How likely is it that another portion of the artery could collapse? I am a 56 year old woman, in good health, active, with weight appropriate for my height, and I do not smoke.
Nelly, Seattle, Washington, USA, August 7, 2012

• JC in Barcelona -- Check out our feature article on last year's GRAVITAS study regarding platelet reactivity, VerifyNow, and double dose of clopidogrel.
Angioplasty.Org Staff, Angioplasty.Org, August 7, 2012

• I had a MI a month ago,I had a stenosis in DA treated with angioplasty and DES PROMUS ELEMENT PLUS 4 x 20 mm. I´m following treatment with aspirin 100 mg and Clopidogrel 75 mg. I did the verifyNow test and my PRU is 215, lower than the threshold of 230, but I read that PRU higher than 213 is related with CV events and stent thrombosis (Comparison of VerifyNow-P2Y12 test and Flow Cytometry for monitoring individual platelet response to clopidogrel. What is the cut-off value for identifying patients who are low responders to clopidogrel therapy?).Should I take double dose?I know that omeprazol can interact with clopidogrel absorption, is it true and should I take the pills with 12 hours between ? Thank you in advance.
JC, Barcelona, Spain, August 7, 2012

• Mohan in Nepal -- part of following treatment is taking the prescribed medications (and that would include one or more for high blood pressure) and also doing what you can to reduce your risk factors -- watch diet and weight is certainly one. And for Kyri in Cyprus -- whether or not a stent is working properly is measured by symptoms and possibly a stress test, if your father is experiencing any symptoms (such as angina). But regularly checking on the stent with an angiogram or CT scan is not recommended. If he is feeling well, then you should worry.
Angioplasty.Org Staff, Angioplasty.Org, August 6, 2012

• Hello, My father is 55 years old and he had a stent implantation in one of the main arteries of his heart last year. Doctors said that all the other arteries are weak and they couldn't put stents into them. So he had a stent only in one artery now he is really worried about it. My question is if he can check the stent somehow. the stent he had is pure metal and he cannot do an MRI. How can he check if everything goes well with his heart and the stent he has? Thank you.
Kyri, Cyprus, August 6, 2012

• Hello sir, My dad (aged-62) had a heart attack for the first time on Jan. 2012. And the stenting was also done to remove the blockage. And after the operation my dad has been following all the procedures that the doctor has recommended us. But still same problem has repeated after 3 months from the operation, It is possible considering that my dad is a little overweight and has a history of blood pressure. For this type of cases what should be proper ways going about my dad's treatment. Please provide me suggestions.
MOHAN, Kathmandu, Nepal, August 3, 2012

• Hopefully the stents you received in Sept and June are the newer second generation stents and that your issues with restenosis (reblocking of stents) may be helped by them, since they have a lower rate of reblocking.
Angioplasty.Org Staff, Angioplasty.Org, August 1, 2012

• I had an MI in 2005 one stent placed. Blood clot caused an MI in 06. In Sept. of 2011 after having severe fatigue and other symptoms 2 stents placed one by the first in lad and one on back side of heart. Symptoms returned before I was done with rehab, they have the records. Finally in June got bad enough that I requested another angio, blocked stent was found. Great to breath again. Problems....I have severe side effects to statins....and beta blockers. I have changed diet, lots of greens very little red chicken green smoothies fruit smoothies of any kind. Not over weight, do not smoke, occasional beer or drink, do not binge on alcohol. Ag producer. Am now 56. Insurance has suggested a pharmaceutical exemption, have no idea what that means. Cholesterol has never been bad, 108 to 125, goes higher when I can't stand statins anymore, but not low enough now for medical recos. Ideas??????
JN USA, self employed, Ortonville, Minnesota, USA, July 29, 2012

• Barry in Thailand --The "latest research" you're referring to is actually 5-6 years old. Blood clots inside of stents, otherwise known as "stent thromboses," were more of a concern in the first generation of drug-eluting stents, although the occurrence was infrequent. The newer stents, one of which you probably got, are pretty much equivalent to bare metal stents in terms of clotting, but far superior in terms of not re-blocking (restenosis). For more info, and more up-to-date info(!), visit our "StentCenter" and in particular our article, "Drug-Eluting Stents: An Overview." Plavix and aspirin for a year and aspirin for life is the typical drug regimen and yes, they are specifically antiplatelet drugs to prevent clots from forming in the arteries.
Angioplasty.Org Staff, Angioplasty.Org, July 29, 2012

• I am very concerned. I had a drug eluting stent about two months ago. I read that the latest research says that these types of stents are more likely to lead to blood clots and death and that they are more dangerous than pure metal stents. This is scaring me. My Doctor said i will have to take Plavix and aspirin for one year,and The later for the rest of my life. Will these drugs prevent these complications.
Barry Wicksman, Chiangmai, Thailand, July 29, 2012

• Praveen in India -- Actually stents were developed as an alternative to the much more invasive procedure of bypass surgery. There are certain situations where bypass is the preferred treatment, but these are becoming fewer as stent technology progresses. And Concerned Brother in Pakistan, your brother has what is known as a CTO, Chronic Total Occlusion. Opening up this type of blockage can be challenging -- there are interventional cardiologists who specialize in CTOs. If the cardiologist is able to open it, he/she will no doubt use a drug-eluting stent, since CTOs are at high risk for reclosure and the latest generation of drug-eluting stents (DES) are the most effective in preventing this (some brand names are Xience, Resolute, Promus). Abbott's ABSORB bioresorbable scaffold system (they don't use the term "stent") was approved in the European Union in January 2011. Don't know its status in India. But a stent doesn't cure coronary artery disease -- it only relieves symptom and improves blood flow. Unless steps are taken to lower risk factors, the disease will progress. So...the best thing your brother can do is to help the stent and reduce his risk of progression of the disease. That means Number One, stop smoking!!. Smoking is the number one risk factor for coronary artery disease. There are cardiologists who refuse to operate on patients who continue to smoke. Number Two, diet, exercise and healthier lifestyle. You didn't mention how tall your brother is, but it sounds like he might be overweight. So lose weight. And, of course, take prescribed medications as directed.
Angioplasty.Org Staff, Angioplasty.Org, July 21, 2012

• My brother 32, 100kg, smokes got a minor heart attack. Got angiography done. The doctor says one of the artery is blocked 100 %. Angioplasty is due in around 15 days. My question is should he get stented? Is it safe? What if the stent fails? If yes, what stent is best for him or the best available in the market? Are bioabsorbable stents available in market or its just under testing? I heard that stents fail sometimes. Please recommend the best possible solution (and stent if it is the best possible solution)
Concerned Brother, Karachi, Sindh, Pakistan, July 18, 2012

• hi, i have an a STENT work positively?? and is there any alternative for it, like bypass surgery??? for the individual of 45 years....or it depends upon the number of blockage in the body????
Praveen, student at kids corner, Delhi, India, July 13, 2012

• H in Saudi Arabia -- general recommendations are for Plavix (or equivalent) plus aspirin for at least one year, and aspirin thereafter. Some cardiologists recommend Plavix for a longer period, depending on a number of factors (location of stent, length, etc.) assuming the patient is tolerating Plavix with no side effects. For more discussion, see our topic on Plavix, Aspirin and Stents.
Angioplasty.Org Staff, Angioplasty.Org, July 4, 2012

• Which is one is better to stop Plavix or Aspirin after 12 months to DES?
H, Riyadh, Kingdom of Saudi Arabia, July 4, 2012

• Sullivan in Germany -- During implantation a stent is expanded to press against the artery wall. This is the same for bare metal or drug-eluting (DES). Removing a stent would be a risky and complicated surgical procedure, requiring bypass, etc. May we ask why you want the stent removed? Within months the endothelium (inner lining of the artery) grows over the metal struts and begins covering them.
Angioplasty.Org Staff, Angioplasty.Org, July 1, 2012

• Is it possible to remove a DES-Stent, which was implanted for 14 days?
sullivan300, Germany, July 1, 2012

• PLJ in Chicago -- see our psot from June 9. It's not so much how long the stent lasts, but how much the progression of the coronary artery disease can be slowed or stopped after the stent is placed. The stent is only a mechanical solution to the blockage. A stent may get re-blocked (called in-stent restenosis) but blockages may occur elsewhere -- nothing to do with the stent. There is controversy about repeated stress tests (especially nuclear stress tests) in asymptomatic patients. There is, after all, radiation associated with a nuclear test, not to mention costs.
Angioplasty.Org Staff, Angioplasty.Org, June 30, 2012

• I had my first heart attack in 2006, I was 28. I have two stents. After one of my stress test, I was told the est. life of a stent is about 15 years. That's why they need to do stress test every few years to make sure there is no new blockage.
PLJ, Chicago, Illinois, USA, June 24, 2012

• Women in Ky and Ram in Tanzania -- Reducing risk factors is the best thing a patient can do after stenting. Getting your cholesterol down, stopping smoking, losing weight and exercise are very important to accomplishing this. Staying on your prescription meds is another. As for diet, every patient has somewhat different ways to accomplish a "healthy diet" -- we suggest discussing this with your doctor. And Barry in Thailand -- you certainly can try "natural" statins, but they may not be effective enough to get your cholesterol down. You should discuss your medications with your cardiologist and make adjustments where possible. We would stress that Plavix (or equivalent) and aspirin are very important medications to take post-stenting, to keep the blood from clotting in and around the stent.
Angioplasty.Org Staff, Angioplasty.Org, June 23, 2012

• at age 60 overweight bad chol is 94 a1c at 6.5 female sat at home for over 12 hrs just had a stent placement what would be my life expectancy? If I got my chol down under 70 and lost 30 lbs?
Women in ky, Louisville, Kentucky, USA, June 23, 2012

• HI My name is ram 37 yrs working in Tanzania. i had a attack on March 2012. i did angioplasty with two stent in one block. I stopped smoking and drinking alcohol. and I'm in diet. walking 25 minutes, taking medicine regularly. can suggest me the life span after PTCA can suggest me Dry red wine and green is it good to heart.
Ram, Dar Es Salaam, Tanzania, June 21, 2012

BARRY, northern marianas college, chiangmai, Thailand, June 18, 2012

• A general comment to all regarding "stent life" -- why stents get blocked up is not usually a problem with the stent itself (there are those very occasionally, but they are relatively rare). What causes stented and other areas in the arteries to get blockages is progression of coronary artery disease (CAD). The stent is metal. It gets covered over by endothelial cells inside the artery and, in effect, gets incorporated into the arterial wall. So the stent itself doesn't "wear out". Because so much of CAD is driven by genetics, patients need to reduce their controllable risk factors and hopefully reduce, slow down or stop the progession of disease. This can be done through diet, exercise, stress reduction and importantly, medications to reduce cholesterol, lipid profile, etc. Angioplasty and stenting can open up a blockage and, with modern stents, the reblockage rate is under 10%. Of course, if you are one of the 10%, it's 100%. Check out our topic on "In-Stent Restenosis".
Angioplasty.Org Staff, Angioplasty.Org, June 9, 2012

• In 1996 I had my first heart attack at age 34, WF, 110 lbs. I had a stent procedure then 3 months later another heart attack. Stent had closed up. 5 years later another heart attack another stent (medicated this time) Same artery different spot in artery. So my chief complaint is an off/on pain high up in my back. Left arm goes numb and I'm tired all the time. Did the nuclear testing. Artery that runs to the back of the heart (stented) is no longer there. Just little capillaries. Clogging up of other two arteries are evident. What do I do? I am feeling like an old patched up inner tube just waiting for the blow out.
msdownsouth, Mississippi, USA, June 9, 2012

• I had heart attack at age 35. one stent put in main artery was 100 blocked. doc is saying i had no heart damage because i got to hospital on time. bad history of heart disease. father passed at 45 grandfather passed at 40 heart attacks. on medication however i feel better than 6 months ago, not sure if heart attack at 35 has decreased my life expectancy or not.
I moten, Chicago, Illinois, USA, June 5, 2012

• Female 57 years old Had an infarct June 2011 RCA 100% blocked- 4 non Rx stent put in, now due to unstable angina had another angio done and it showed a 90% blockage of left CX, non Rx stent put in. How can this blockage happened. Was on Plavix coversyl bisoprol A.S.A. and Crestor.. what are the risks that other blockage will happen...thanks for any input..
JC, L'Ancienne Lorette, Quebec, Canada, June 5, 2012

• Donald B -- We should all take care of ourselves as well as you have. Congratulations on achieving such good health -- and keeping it. Gives all of us encouragement. As for whether you need to get an angiogram, possible angioplasty...the question is whether you have ischemia, whether your shortness of breath is a symptom of that, and whether the stress test was a false positive (stress tests do have a relatively high false positive rate). One possibility would be to do a CT Angiogram, which is non-invasive and takes only minutes -- this avoids any complications from an angiogram. It can image your arteries and show if you have a blockage that may need addressing. If it shows no blockage, then studies have shown that CT Angiograms are 99% accurate for negatively predictability -- in other words, if the CTA shows no disease, then you have no disease. Unfortunately, mny insurers don't cover this. The standard pathway recommended for stable patients, like it seems you are, is to try medical therapy and, if that doesn't provide relief of symptoms that are affecting your ability to do things, then think about an invasive procedure, like a stent.
Angioplasty.Org Staff, Angioplasty.Org, June 5, 2012

• I am a 90 year old man with abnormality on stress test in the area served by the left anterior descending coronary artery. I am otherwise in rather good condition and competed in 2007 senior Olympics swimming and received a gold, a silver and a bronze medal plus 4th and a 5th in my two other events. The question is whether to have a cath and possible angioplasty and stenting or to have medical treatment. I have shortness of breath on exertion but no angina.
Donald B., Kingsport, Tennessee, USA., June 3, 2012

• I am 45, 70kg, had done RCA (100% blockage) last month in may-2012 stented family history positive, no smoking, no junk foods walking exercise up to 2km daily. I had met with cardiologist once there is another blockage in LAD 80%.drug clopidogrel, aspirin, atorvastatin 80mg now which exercise to be done and should i drive the bike while walking fast or continuous after 15 min. i get the pain in RCA so should i consult my cardiologist.
jbr Bombay, Mumbai, India, June 1, 2012

• Nag in Toronto -- The best situation is if your cardiologist AND the surgeon could discuss this with each other. In this way they can let each other know why they feel their prognosis is correct. Some hospital centers already make this a standard practice, having doctors from different specialities consult together and come up with the best solution for their patient. Are you having symptoms? The question for your doctors is why, after having two stents put in to open your arteries, would you still need surgery?
Angioplasty.Org Staff, Angioplasty.Org, May 31, 2012

• I just recently had 2 stents put in. I'm 41 years old and the Interventional Cardiology doctor said I wouldn't need bypass. The staff surgeon doesn't agree he feels surgery is necessary, whom do I listen to?
Nag, Toronto, Ontario, Canada, May 17, 2012

• Diane in Dublin -- Excellent question -- and one that will elicit a range of responses from cardiologists. Plavix (Clopidogrel) is an antiplatelet drug that is prescribed for heart patients, not just for prevention of stent thrombosis (clotting in the stent). In fact, in the U.S., the drug itself is not indicated for use after stenting. What this means is that the company that makes Plavix (Bristol Myers Sanofi Aventis) never conducted the required studies or submitted data to the FDA. We have written about this confusing issue often (see "The Catch-22 of Plavix and the FDA: Not My Job"). As to whether more than one year of Plavix would make for better outcomes, a very large study is currently underway, called DAPT, testing 12 vs. 30 months of Plavix post-stenting. The rule of thumb right now seems to be that, if a patient tolerates the drug well and has no surgeries coming up, he/she might want to consider staying on Plavix. Some studies have shown that little or no benefit is gained by staying on past six months. Finally, each patient is an individual, and the anatomy of the coronary arteries, where the stent is placed, how long it is, what the genetic markers for platelet reactivity are, etc. all contribute to making a judgement about whether or not the patient is at higher risk for thrombosis, and therefore might consider staying on Plavix. You can read more about these issues in our Forum Topic, "Plavix, Effient, Aspirin and Stents".
Angioplasty.Org Staff, Angioplasty.Org, May 9, 2012

• After reading many of the posts, I am wondering why Plavix would be given for just one year after a stent is inserted. Is it unusual to be still on Plavix six years later? Many thanks
Diane, Dublin, Ireland, May 9, 2012

• D. Griff in Canada -- As we've written below, it's not really a matter of "stent life" so much as the progression of the disease. The stent is metal. It gets covered over by endothelial cells inside the artery and, in effect, gets incorporated into the arterial wall. So the stent doesn't "wear out". Patients have the ability to reduce their risk factors and hopefully reduce, slow down or stop the progession of disease. As you have written, you did this. But, as you also have noted, the disease is also driven by genetics. Some patients need repeat procedures within a year, some several years. You lasted eight. Adolph Bachmann, the first angioplasty patient whose picture is at the top of this page, had an angioplasty in 1977 and is fine today, 35 years later. By the way, we're curious why the 90% blocked stent required a bypass, and not another angioplasty. Were there other arteries blocked?
Angioplasty.Org Staff, Angioplasty.Org, May 6, 2012

• Hi, I'm a 54 year old male who had 100% blockage of the RCA 8 years ago. I had one stent put in to restore blood flow and have been on cholesterol meds, aspirin, and beta blockers ever since. About 7 weeks ago I had a recurrence of the symptoms from my original heart attack and went to the emergency dept. I since, have had a double bypass operation. The stent I had implanted 8 years prior was 90% blocked and required bypass. I was told by several Drs, surgeons, and other medical professionals that "8 years isn't too bad for a stent"! I was dumbfounded, since I was never told anything like this when it was originally put in...I assumed it was a "permanent fix". Since the stent was put in I have been extremely careful with diet, exercise, taking my meds, and not smoking....It would seem genetics are a huge contributing factor.
D. Griff, Surrey, Canada, May 3, 2012

• Dani -- We are most sorry for your loss. Regarding the topic you've posted to, "stent life", the problem is usually not that the stent fails, but that the coronary artery disease (CAD) advances and continues to cause problems. Stents are not "replaced" per se, although if they block up, they can be reopened with a balloon or another stent. After stenting, patients need to reduce all their controllable risk factors to slow or stop the disease -- and it sounds like your fiance did all that. But the fact that he had a heart attack at 19 is certainly not normal. That's an extremely early age to have a level of coronary artery disease capable of causing an infarction. So there were most likely other things going on physiologically. Should an angiogram have been done? Easy to say with hindsight. But there is a non-invasive type of test, called a CT Angiogram, which can be done quickly and easily. Yes, there is radiation, but modern state-of-the-art technology and low-dose protocols have reduced the radiation considerably. Such systems are starting to be used in emergency departments to test patients who complain of chest pain. The question would be whether he did indeed have a heart attack, whether the heart attack was caused by a blockage in the stented artery...or a different one. Sadly, the damage is done. Hope this is of some help.
Angioplasty.Org Staff, Angioplasty.Org, May 3, 2012

• Hi, my fiance had a sudden heart attack when he was 19 (2006) and had a drug eluding [eluting] stent fitted in his left main artery. He often had chest pains and the doctors switched around his medication. He died 3 weeks ago from a suspected heart attack. He was 25 and active, healthy, non-smoker. My question is do you feel that due to the pains he told docs about, should that have been followed up with an angiogram? He had yearly appointments with a cardiologist and all they did was listen to his chest. No ECG or anything. Last stress test was December 2010 and last angiogram was December 2008.. At his annual appointment in March I asked about an angiogram and the doctor said no due to the possibility that the radiation can cause cancer later in life. Also, with someone his age, should his stent have been replaced after 5 years or at least checked? When he died he had had the stent 6 years and 1 week. Any answers would be appreciated, thanks, Dani
Dani G, Dublin, Ireland, May 3, 2012

• Sachin in India -- What reduces your life expectancy are the risk factors for coronary artery disease, which you have. So doing all that you have done is very important. Having a stent, per se, doesn't lower your life expectancy -- it's the progression of the disease that does. Staying compliant with your medications and changing your lifestyle, as you have done, are big steps forward. As for the proper level of activity for you, check with your cardiologist who has more information about you than any remote source on the internet could. But, assuming all is well, there's no reason why you should be able to lead a full and active life! And, oh yes, tell all your friends to stop smoking -- it's one of the worst things anyone, especially anyone with a tendency for heart disease, can do to their body.
Angioplasty.Org Staff, Angioplasty.Org, April 30, 2012

• Hi i am 32 had angioplasty (stent) recently a month back, after 1 month rest i came back to Europe and resumed my work. I have made lifestyle changes like -(quit smoking and drinking), reduced stress reduced number of working hours, eating less oil food, walking as much as i can.... how ever i have following fear please clarify- does angioplasty (stent) insertion reduces my life expectancy ? even after having healthy diet and life style changes.- should i not lift weight forever in my life, cant i play football or cricket.- can i resume normal sex life as before?
Sachin, Bangalore, India, April 26, 2012

• Saqib -- The stents you mention are the most current state-of-the-art devices. What you need to do is to change your lifestyle as much as possible to lower your risks for future events. Stop smoking, watch your diet, exercise, and stay on your meds. You should be able to be active, play tennis, etc. -- but we'd certainly recommend checking with your cardiologist about your desired level of activity, because he/she will have the specific information about the status of your heart muscle, etc. and should be able to give you a plan to follow.
Angioplasty.Org Staff, Angioplasty.Org, April 25, 2012

• Hi, I'm 38yrs& 8months old. Had acute MI on 4th Apr. 2012 and underwent through Primary PTCA & stenting to RCA 2 stents & LCX 1 stent. one artery was 100% & the other was 95% blocked. family history, smoker, on cholesterol med for 2yrs & tot chl is 163 but TG 298. My question is that i have 2 stents which are Biomatrix flex 2.5mmx18mm & 3.5mmx18mm and 1 stent Xience Prime LL 3.0mmx38mm all drug eluting. How is the reputation of these stents and their life. Also what physical activities i should do as there is no rehab facility or advice available in my country. I want to live normal life, will it be possible? will i be able to play tennis? i,m taking clopid, rolip, fenocap, nidocard, ramicard, cardizem, nexum, rostil, rivotril
Saqib, Dhaka, Bangladesh, April 23, 2012

• My 2 stainless steel stents were put in 1996 - they are still doing their job now 16 years later. He will be fine.
Betty Boop, Sr., Cary, North Carolina, USA, April 22, 2012

• Noor in Dubai -- Our Forum Topic on Exercise, Sport, Physical Activity After Stent has many stories of marathon runners, bikers, weight-lifters, etc. resuming normal activity after stenting. As with any medical situation, however, every individual is different: their reaction to drugs, their ability to resume normal function, etc. That is why we (and any web site) do not and should not provide medical advice in place of an opinion from a medical professional. We would think there are two areas you should discuss with your doctor regarding pregnancy: (1) your own physical condition and any complications that might arise with the increased weight and demands (there may be nothing abnormal here) and (2) any cautions about the medications you need to take, to make sure that they are safe to take during pregnancy. We can say that guidelines for aspirin and Plavix after a drug-eluting stent are for one year to prevent blood clots inside the stent. If, for example, a Caesarian section needed to be done, Plavix (clopidogrel) and aspirin might present some concern about bleeding complications -- although you'd most likely be off of Plavix by that time. Again, this is an important decision and a question that you really need to ask of your cardiologist or doctor, especially one who has all your records, results, and who knows you as a patient.
Angioplasty.Org Staff, Angioplasty.Org, April 21, 2012

• Hi. Am 40. Had angioplasty two weeks back after suffering severe pain in my chest, jaws and shoulders for a week. A single drug coated stent was inserted in an artery that the doc said was 95% blocked. My question is, is there any possibility that I might be able to bear a child after this? I am hypertensive but now am taking Aspirin, Plavix, Cozar, Concor and Lipitor and BP is normal after the angio. Thank you.
Noor, Dubai, United Arab Emirates, April 20, 2012

•Hugh from Texas -- Glad to hear you're doing well. Dual antiplatelet therapy (DAPT) is recommended for a year after drug-eluting stents are placed. So your doctor is following the guidelines, taking you off the heavy duty blood thinner, but keeping you on low dose aspirin. Stay with the program, and watch diet, weight, exercise, don't smoke, etc.
Angioplasty.Org Staff, Angioplasty.Org, April 20, 2012

• I had a drug-eluting stint [stent] put in over 15 month ago in my LAD Artery. No heart attack or muscle damage. My cardiologist said I now can stop taking Brilinta but continue 81mm of Aspirin. Am I OK doing this? I am also on Crestor and Niaspan and my numbers are great!
Hugh from Texas, North Richland Hills, Texas, USA, April 19, 2012

• This is for the few of you that have a stent in the VENOUS system, such as the Superior Vena Cava. When I had mine put in I was told no problem, ever will occur. But when three years later I developed the symptoms of SVC Syndrome, I was told 5 years is often all you get before they become occluded. Apparently the low flow makes things worse.
H., Huntington, New York, USA, April 18, 2012

• Terry in Thailand -- Patients with coronary artery disease should do whatever they can to lower their risk factors. This includes lifestyle changes (smoking cessation, diet, exercise, stress reduction, etc.) and medications, if they are prescribed, for example, statins, blood pressure meds, etc. Plavix is required for a year minimum after a drug-eluting stent. Whether or not it also could be of benefit to you at this point is something you should consult with a cardiologist about. There are several well known heart centers in Bangkok where you should be able to find a healthcare provider to guide you. As for your totally blocked artery, check out our Forum Topic on Chronic Total Occlusions.
Angioplasty.Org Staff, Angioplasty.Org, April 14, 2012

• I had 3 stents implanted 3 years ago. The doctor told me that my other artery was completely blocked, serving my heart. I am in Thailand and don't know if I should be taking any meds. I do take aspirin each morning...but what about Plavix? My blood pressure is normal. I don't know who to ask or trust here. Thanks.
Terry, Pattaya, Thailand, April 13, 2012

• Dennis in California -- That's a pretty dramatic MI! Lucky you were able to land and get to a hospital. Although, according to guidelines, your HDL should ideally be higher, your total cholesterol is low and your EF, etc. are okay. (How's your weight, by the way?) It sounds like you are doing what you can to lower your modifiable risk factors, but there's that darn family history! We would say keep doing what you're doing. We assume it was your blocked Right Coronary Artery (RCA) that was the nucleus of your heart attack, and that's been opened. Your doctor is right; it's not possible to stent small diffused vessels in what's sometimes called the "microcirculation", but your body also can compensate for any blood flow deficit by creating corollary circulation. As for "stent life", aside from the very rare instances of stent fracture, the stent is a permanent implant which gets incorporated into the arterial wall as endothelial cells grown over it. Drug-eluting stents, like the Xience, emit a medicine for the first few months which keeps those cells from growing too much, and reblocking the stent. It's not the life of the stent, but the progression of the disease that needs to be controlled which, as you report, you are doing. Good luck and keep it up!
Angioplasty.Org Staff, Angioplasty.Org, April 3, 2012

• I had Xience stent in my RCA after an MI on a plane a year ago and emergency landing. Thallium stress test one month later and one year later both showed ejection fraction of 60 percent. Diabetes type 2, hba1c 6.8, LDL 60, HDL 45. 54year old male. Exercise daily. Family history, non smoker. How long can my stent last? Take Plavix, aspirin, Simvastatin, oral diabetes drugs. Angioplasty at time of operation showed only RCA blocked but four other diffused capillaries occluded. Do i need to worry about those? Doctor said leave them alone.
Dennis, San Jose, California, USA, April 3, 2012

• Francis in California -- Good questions. We'll try to answer them one-by-one. As for being able to minimize the risk of restenosis, it's important to take your prescribed medications and stay with a healthy lifestyle, which it seems you have. Unfortunately, genetics plays a role in coronary artery disease, and it's not one that we can yet control. You prefer not to take drugs, but the three you are taking are important. Plavix is an antiplatelet drug and keeps the blood from clotting. There is some evidence that statins may reduce plaque formation but this is not something yet proven in clincal trials. As for endothelial formation, the Endeavor is unique in that it has been shown in OCT studies to have completely covered metal stent struts in less than 3 months, an outcome that occurs more quickly and more completely than with bare metal stents. There was a study from Korea presented just this past weekend at the American College of Cardiology meeting that 3 months of antiiplatelet therapy may be enough in some patients with the Endeavor stent. But for now, one year is the recommended duration. Hope this answers some questions.
Angioplasty.Org Staff, Angioplasty.Org, March 27, 2012

• I am a 79 year old male, do not smoke or drink (although I did 25 years ago) am at my correct weight, have a good, rational diet, and have always been quite active physically. My cholesterol level has always been high but in the normal range. I had pain in my chest twice in January of this year. The first time I went to the hospital emergency room and the tests showed that I probably did not have a heart attack. A few days later I felt chest pains and went to the hospital a second time. The next day, January 26, a Medtronic, drug-eluting Endeavor stent was installed in my left anterior descending artery. I now take Plavix, aspirin and Zocor. I prefer not to take any drugs if possible.
1.Regarding restenosis: Can change in life style (diet, exercise, etc.) have any effect upon the excess formation of endothelium cells? Does the patient have any control over this healing process at all?
2. Does Plavix or Zocor have any effect (pro or con) on the endothelial formation?
3. If the drug on (or in) the stent delays formation of the healing endothelium, why not stay with bare metal and thus reduce the time drugs must be taken?
Thank you.
Francis, Retired Man , California, USA, March 26, 2012

• Ron in New Mexico -- The Promus is a second generation drug-eluting stent (DES). The drug used is everolimus. The Promus is sold by Boston Scientific and is identical to the Xience V sold by Abbott (a sharing agreement which soon will end). Promus/Xience is the most widely used drug-eluting stent and has shown significantly better results than first generation DES, such as Taxus and Cypher. Recommendations for dual antiplatelet therapy (Plavix or Effient and aspirin) after DES implantation are for one year minimum. Your cardiologist may recommend a longer period for any number of reasons, so that's a conversation you should have with him/her.
Angioplasty.Org Staff, Angioplasty.Org, February 10, 2012

• What type of stent is this? Promus 3.0mm x 12mm lot 1051041s81560 ref 1009547-12b otw. This is all the info that is on the card I keep in my wallet. Will I have to take Effient for the rest of my life with it? It was installed after a heart attack, 100% block of the LAD.
Ron, Roswell, New Mexico, USA, February 9, 2012

• I am a 56 year old woman who never ate fast food, prepared meats or prepared food. At 54 had stent in my RAC [RCA] then 7 months later 85% blockage in my LAD..14 months later, needed the RAC [RCA] restented because of restenosis. Am going in again because I am having chest pain, arm pain, and shoulder pain...Think the LAD has restenosis I take Effient, Crestor, aspirin, Imdur, Toprol, BP medication. I am lean and exercise every day and do not smoke. I live a very healthy lifestyle but have lipa A issue..Genetics play a big role in disease..
jm, Fort Myers, Florida, USA, February 9, 2012

• BDH in Tennessee -- There are actually recorded cases of patients with 20 or more stents, but this is rare.... The fact that his bypass is still open after 20 years is good. He should continue to control his risk factors and obviously it would be better if he could lose some weight. But the fact that his blood work, etc. are good is a positive sign. As for fatigue and not feeling "right", it's good that he is seeing his doctor. It may be that his medications need adjustment. Does he see a cardiologist regularly??
Angioplasty.Org Staff, Angioplasty.Org, February 9, 2012

• My husband has several stents - probably 9 or more. Is there a limit to how many can be used. He does fine for a year or so, then more blockage. One doctor even suggested that he might have a heart transplant which freaked us out! He had bypass surgery at age 36 for main artery (1 graft) and it is still open. He is now 56 and every time he feels tired or any pain, I anticipate the worse. He has a stressful job but he says he enjoys the challenge. He is overweight and has diabetes that is controlled with meds. I am terrified that he might have a heart attack or worse. He is on several meds and his recent blood work was very good. He is going to see family doc this week due to fatigue and not feeling "right". What are your thoughts please. Thank you kindly.
BDH, Knoxville, Tennessee, USA, February 8, 2012

• Bill in Mexico -- Your question is a bit off-topic here. See our Forum Topic on "Financial Assistance for Plavix". You mention pain in your arm. Did you have an angioplasty where the cardiologist used the wrist (radial) approach? As for how long to take Plavix, didn't your cardiologist tell you? If you received a drug-eluting stent, you need to be on Plavix and aspirin for a year.
Angioplasty.Org Staff, Angioplasty.Org, February 2, 2012

• Hi my name is Bill. Last July I had two stints [stents] put in after a heart attack and bypass surgery. One month later i have pain in my right arm from wrist to elbow how long will it last and how long will i have to take Plavix the cost i have no insurance.
Bill, carpenter retired, Mexico, February 1, 2012

• Swilson in Mississippi -- Check out our Forum Topic on "Exercise After Angioplasty".
Angioplasty.Org Staff, Angioplasty.Org, January 15, 2012

• I am 48 and I just had a 90% blockage in my "widow maker"artery, doctor said it was a main artery. It has not been a week yet. They said I was lucky and didn't have heart attack. Can you tell me how long I need to wait to start exercising? I going back to work tomorrow, and how extensive can I exercise starting out?
Swilson, Smithdale, Mississippi, USA, January 15, 2012

• As for recovery, the concern after a heart attack is what, if any, damage occurred to the heart muscle. If deprived of oxygen for an extended period, some of the muscle can die. This is why opening the blockage with angioplasty, performed in an emergency situation (during or within hours of the onset of symptoms) can literally stop a heart attack in its tracks and preserve the muscle. One measure of this is the ejection fraction or EF, which your husband's cardiologist can discuss with him. As for the life of the stent, a stent, once placed, is permanent. What may fail is that excess tissue growth may occur inside the stent, known as instent restenosis. This is a variation of what caused the blockage in the first place. It can be treated using a balloon inflation, or even another stent inside of the original. With the new generation of drug-eluting stents, this occurs in the low single digits, maybe 5 out of 100 cases. Much rarer is the possibility of a blood clot forming inside the stent, called stent thrombosis. This is lessened significantly by taking the prescribed dual antiplatelet therapy (DAPT) of aspirin and another anti-clotting drug, sometimes Plavix or Effient or Brilinta. So taking prescribed meds is very important, as is lifestyle, diet, weight control, exercise and not smoking. Obviously in your case, family history is there: something we can't (yet) alter. But millions of people worldwide have had stents and returned to full productive lives. For example, see our Forum Topic on "Exercise After Angioplasty" for some stories of atheletes who have continued to run marathons, etc. after stenting.
Angioplasty.Org Staff, Angioplasty.Org, January 15, 2012

• My husband had a stent put in today after having a heart attack. He had chest pains on Tuesday so they assume he had a mild MI then as well. We are both worried about his recovery and the life expectancy of the stent. He has a family history but is 47 and does not drink or smoke and does exercise regularly. Any advice or comments to keep him healthy?
RM MSW, Los Angeles, California, USA, January 14, 2012

• June in London -- We assume you meant your heart attack was in 2011, and we're guessing it was October 3 (not March 10). Can you tell us if the stents were put in during or very shortly after the heart attack -- or was it days later. The question for your doctors would be what is your ejection fraction (i.e. what is the status of your heart muscle) -- a heart attack can damage the muscle, reducing its ability to function fully. This is also something that patients may be able to improve somewhat with proper rehab (exercise, meds, etc.). But certain medications can also cause fatigue, etc. so you should go through your symptoms and your medications carefully at your cardiologist appointment. Perhaps an adjustment in dose of type of med could help. Most importantly, if you don't understand something he/she says, ask it again until you do. Your understanding of what you are taking and why you are feeling the way you are, what you need to do and what you can expect in the future will help put you in more control of your health which will help you maximize your recovery. Also check out ou related topic: "Heart Attacks and Stents or Angioplasty"
Angioplasty.Org Staff, Angioplasty.Org, December 23, 2011

• hi had a heart attack on 3/10/12 had 4 drug releasing stents put in i am 50 years old am still having problems with my breathing have no motivation and still very breathless Dr says this is normal surely i should be feeling better by now diabetes is still hi own GP says this is OK too not seeing cardiologists till late January wanted to return to work in February no way can i feeling like this please any advise is this normal?
June, London, England, December 15, 2011

• Djjm in Pennsylvania -- You should look at our topic, "Allergic Reactions to Drug-Eluting Stents". Most stents are finished eluting their drug by 60-90 days. But you husban may be allergic to the polymer (plastic coating on the stent) or possibly to one of the drugs he started taking at the time of stenting.
Angioplasty.Org Staff, Angioplasty.Org, December 10, 2011

• My husband had stents put in 9 months ago. Ever since, he's suffered with his throat clogged with mucus. I suspect the drug in the stent has caused an allergic reaction. How long does the drug elute from the stent? How long will he suffer with his throat? What OTC drug can he safely take to help with this problem?
djjm, Newville, Pennsylvania, USA, November 23, 2011

• Arvind -- It's not the "life of the stent" so much as the recurrence rate. In most trials and studies, the restenosis (reblocking) rate for drug-eluting stents runs well less than 10%. By controlling your risk factors (BP, diet, exercise, smoking) you can minimize this rate. And by the way, to all posters, PLEASE TURN OFF YOUR CAPS LOCK WHEN POSTING. It's the equivalent of shouting....and we hear you.
Angioplasty.Org Staff, Angioplasty.Org, November 12, 2011

ARVIND, retired one, Lucknow, India, November 9, 2011

• Sarah64 -- It's not a delicate question. Someone who has had heart attacks and five stents and continues to smoke is just waiting for the next one. Your friend is very lucky he's made it through the past five years. Smoking has been shown clearly without any doubt to be a major risk factor for heart disease, not to mention cancer, COPD, etc. But it's not a lifestyle choice: smoking is an addiction and needs to be treated the same way. Some people can stop by themselves (I did -- a long time ago) but some need outside help, support group, etc. Stress is not necessarily bad -- there is good stress, but there is no "good" smoking. The best friend you can be is to help your friend recognize this problem and deal with it.
Angioplasty.Org Staff, Angioplasty.Org, October 30, 2011

• Hi there- I would like to ask a somewhat delicate question. My friend is 47 years old and has suffered two minor heart attacks. After which he was rushed to hospital and had 5 stents put in. This happened five years ago. Despite the warnings and though he takes the prescribed medicine for the condition, he has not changed his lifestyle and continues to live a stressful life and smokes heavily. What is the life expectancy for an individual who continues so under the mentioned condition? Thank you for your help.
Sarah64, England, October 22, 2011

• Bypass surgery and optimal medical therapy are the two real alternatives. Some people who continue to experience angina even after stenting or surgery find ECP useful (see our topic on EECP and ECP).
Angioplasty.Org Staff, Angioplasty.Org, October 10, 2011

• what alternatives to stent exist?
Arby, retired, Ottawa, Ontario, Canada, October 5, 2011

• Cristobal899 in South Carolina -- if you have received a stent, then you have coronary artery disease. This is a chronic medical condition that needs to be managed by reducing as many risk factors as possible. Sounds like you are doing that, taking the prescribed meds, exercising, etc. We assume you don't smoke. And that is all good and should allow you to lead a normal life. Of course, anyone with coronary artery disease should get a checkup and visit their cardiologist once a year, just to stay on top of the disease management. It's not so much to "check on the stent", but to make sure the disease is not progressing and that your meds are working, etc.
Angioplasty.Org Staff, Angioplasty.Org, August 22, 2011

• Does stent need to checked yearly or every 6 months. Can you tell me how often stent must be checked. I got my stent 2008 and i have checked it one time since i got it. I still taking medicine for high blood pressure and statin to lower my cholesterol and i do exercise and my work is in the kitchen so i moved a lot and sweat a lot. Sometimes i feel chest pain and it goes away quickly not often. If only i am stressed out and tired that is the time i got some chest pain. Do you think i need to have a check up?
Cristobal899, Hilton Head, South Carolina, USA, August 15, 2011

• Sara from Tehran -- Your concern seems to be how long will a person who has received a stent (the Endeavor from Medtronic in this case) continue to live? And how long does it take for the stent to "heal". Optical Coherence Tomography (OCT) imaging has shown the Endeavor to be virtually "healed" at six months. The clinical evidence from various trials shows a very very low incidence of late stent thrombosis. As for how long can someone with a stent live? That's a more complicated question. Coronary artery disease is not cured by stenting, or bypass surgery, or by medicines. It is a chronic disease. But it can be controlled, slowed down, even stopped or reversed by reducing risk factors: stopping smoking, good diet, exercise, etc. and taking medications where prescribed to reduce cholesterol, blood pressure, etc. A stent can intervene in an acute situation that is causing angina and stop it. Angioplasty can open an artery that is causing an infarct (heart attack) and stop the heart attack. But life expectancy is something that has many factors, clinical situation, genetics, etc. The very first patient to ever have an angioplasty is still alive and active (and a very positive man). We have spoken a number of times. And his angioplasty was in 1977!
Angioplasty.Org Staff, Angioplasty.Org, January 21, 2011

• Hi again, Thank you for your answer, But I still have not got any appropriate answer. Yes, May be I should have said how long "last" a person with these everolimus eluting stents. Now please 2 Questions:
1. How many years can one live with an everolimus eluting stent and still "last" ? (or better say still be alive?) you know in case of sudden thrombosis, nothing further helps. And, you have said: "the Endeavor from Medtronic has shown complete healing at 6 months -- it seems to act like a bare metal stent"
2. Would you please tell me how long should man wait for complete healing of EES? months ? years ? ever ? Thank you. Sara --
P.S. Sure there is no use when a stent lasts and the fellow is gone! and I've not found anything in "your articles" about this matter . (but in other's articles and books in USA) Thank you again for your answer.
Sara, Tehran, Iran, January 15, 2011

• Sara from Iran -- read over our chief article on "Drug Eluting Stents". There's nothing that says stents, bare metal or drug eluting, only "last" for so long. Except for a rare case of fracturing, once a stent is implanted, it's permanent. What you may be referring to is how long does the artery stay open, because a stent (or angioplasty or bypass surgery) doesn't "cure" the disease and reclosure is a possibility -- although the chances of that are much lower with drug-eluting stents. As for the endothelium healing, most drug-eluting stents do delay healing (the Endeavor from Medtronic has shown complete healing at 6 months -- it seems to act like a bare metal stent) but the healing ultimately occurs with the other DES over time. Hope this helps.
Angioplasty.Org Staff, Angioplasty.Org, January 5, 2011

• Hi there -- How long will a drug eluting stent (for example everolimus eluting stent) last? I've heard so much about good lasting of bare metal stents but have heard (and read in medical papers and books and resources) that drug eluting stents just last 4 or 5years!!!!!!!!!! Because the endothelium can't be healed (as a result of drug) and there would be a plaque! Yes Plavix , but what about 2 years later when no Plavix is taken? Please tell us HONESTLY how long a "drug eluting stent" lasts? How many years? ( sure I mean coronary ones). Thanks in advance
Sara, Tehran, Iran, January 1, 2011

• I was 37 when I had angioplasty. After 11 years, my recent stress test has come positive at very high work loads. What do I need to do. All my parameters BP, Cholesterol, Diabetes etc are absolutely under control and normal. Is it possible that the stent put in angioplasty has started reblocking. If so, what is the solution. Pl advise.
TML, Mumbai, India , June 11, 2010

• DRM -- A stent lasts virtually forever. After placement, the metal stent gets covered over by a thin layer of endothelial cells and is incorporated into the wall of the artery permanently. If too many cells start covering, then restenosis or reblocking occurs. The stent is still there, just reblocked -- it can be opened by a balloon or even another stent placed inside (off label in the U.S.). This reblocking happens 5-8% of the time with a drug-eluting stent. A new idea being developed is the bioabsorbable stent, which will disappear after 6-12 months -- after it has done its job of keeping the artery open after balloon angioplasty. The best way to help keep the stent from reblocking is to reduce as many risk factors as possible (diet, exercise, smoking cessation, medical therapy as prescribed, etc.)

As for your husband's age -- 32 is young, but Adolph Bachman, the first patient to ever have an angioplasty, was 37 at the time, which was the year 1977. No stent back then, but he is now 70 and feeling great. A few years ago, for the 30th anniversary of the procedure, he traveled all over the world giving speeches about his experience.
Angioplasty.Org Staff, Angioplasty.Org, May 1, 2010

• My husband is 32 , 94 kg, had single vessel disease, stented , family history positive, no lipid prob, no smoking. What is the life of the stent ? 32 is it a very young age? He had 80% block on angio.
DRM, Bangalore, India, May 1, 2010

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