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Allergic Reactions After Drug Eluting Stent (DES) Hypersensitivity (2008 archive)

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Post to this topic if you are concerned that you may be experiencing an allergic reaction (hypersensitivity) after a drug-eluting stent (DES) procedure.

Other postings can be found here: Current, 2009, 2007, 2006, 2005.

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Archived Postings from 2008 (42):

• My husband has been on Plavix since January of 2008 after stent surgery. He has been suffering with a painful and itchy rash and his skin is all blotched. We have exhausted our general physician, heart specialist and dermatologist. We are going to another dermatologist in Boston hoping to get to the bottom of his rash. We feel now it is either the Plavix or the medicated stent (Taxus Express 2 Paclitaxel-Eluting Coronary Stent System.)
D., Londonderry, New Hampshire, USA, October 20, 2008

• 4 weeks post drug eluting stent placement, I have developed intense itching over most of my body - including palms of hands, soles of feet. My Cardiologist doesn't think I am having a reaction to Plavix due to late onset of itching and he doesn't think it is the stent because the stent that caused allergic reactions hasn't been used for years? Does anyone have more information on the rare, but real, allergic reaction to stents?
Mary P., Kalamazoo, Michigan, USA, September 3, 2008

• My husband had 2 taxus drug eluding stents put it 6 months ago. When does the drug wear off the drug eluding stent? How long does this take? months, years, etc.? Does anybody know, thanks.
Stephanie, Louisiana, USA, August 3, 2008

• A general note to all -- we are very interested in seeing posts from patients who think they may be having some type of allergic reaction after stenting. Such a reaction may be due to a new medication that has been introduced, so that's the first suspect. Patients should discuss this possibility with their cardiologists. Another possibility is a metal allergy, and we've discussed that a number of times. A third possibility is an unexplained and ongoing reaction and in those cases we'd also recommend that patients contact Angioplasty.Org specifically for information on the research study being conducted in Texas. This phenomenon has not been widely studied (this Forum is one of the few places on the internet collecting this information) so most cardiologists will not be aware of it. You can get more information by emailing:
Angioplasty.Org Staff, Angioplasty.Org, August 1, 2009

• I had a heart attack in October, 06. The doctor performed an emergency catheterization and inserted 2 Cypher Drug Eluting Stents on my RCA and insert another stent to my CX a few days after the first 2 stents. A week after I was discharged, I went back to ER again, I felt dizzy, weak, pain on my chest, leg and whole body and some rashes and when I was hospitalized again for 3 days I was told that my blood pressure was down around 70/48 and my pulse was 45-50 per minutes, so they decided to took all my medicine away and re-start each 1 at a time and the doctor took away the Toprol XL and lipitor and I was discharged. But even after 2 months, I occasionally felt like having another mini heart attacked when chest pain (sharp pain) rashes break out, nausea, headache, tired, weak and dizziness. There has been time that the rash broke out and the bubbles was as big as gum ball from the street machine, and I had half of my face swollen a couples times. I had been back to the Cardiologist and asked if I might have Metal allergy and he told me , he NEVER HEARD of anything like this and ask why am I wearing a necklace and have no issues. I would like to participate in this Stent Allergy Study program and I do need to make myself feel better. I have not been feeling all right since the stents had been placed into my heart, please help.
HT, Quincy, Massachusetts, USA, July 31, 2008

• I am a 52 yr old male, who two weeks ago had a drug eluting stent placed in my left coronary artery and my right one ballooned. Feeling great two days later, I thought all would be well, then I began having chest pains and trouble breathing. I went right back into hospital and my cardiologist went back in to see if all was well. He found my arteries were wide open and could not see ne thing wrong. He mentioned I may have acid reflux, so we began looking into that. In the meantime, i woke up at 2am a week after having the stent put in, with rash, itching and swelling. It got so bad that my mouth and eyes were two times the size. Again, I went into hospital. They put me on steroids and Benadryl. The rash went away but the swelling took a little longer. After the steroid treatment, my B/P dropped to 79/32. Gave me fluids and it slowly went back up. I was watched for a couple hours, the dr. thought I may be allergic to the Plavix they had put me on or the B/P medicine lisinopril. The dr. took me off those and put me on ticlopidine and amlodipine. They also sent me home with presc. for prednisone and hydroxyzine for the rash and swelling. They work, but as soon as they wear off and I should take another... the symptoms return. My cardiologist never mentioned anything about a possible allergic reaction to the stent. What should I do now?
N. Ganz, Rhode Island, USA, July 31, 2008

• Following a failed triple bypass, in May 08 my mother (57 yr/white) had two Taxus stents put in. She left the hospital on Tues, she did not have her Plavix on Wed, and then had a heart attack on Thurs morning. One of her stents had closed. Of course, all the medical professionals say it was b/c of her missing her Plavix just one day (why is it you have to stop taking Plavix 5 days before a medical procedure then?). Anywho, they opened the stent back up and sent her home. She has been breaking out with rash/hives ever since. Started on her left arm, and has completely covered her body thus far. They initially took her off Ramopril and has been off it for 2.5 weeks, and now they have taken her off of Plavix for a week now. As of yet, no change with her rash. She also has shortness of breath, fever,sweating, and extreme itching. This has been going on since May.
Tammy L., South Carolina, USA, July 20, 2008

• Gail -- drug-eluting stents were not approved in the U.S. until late 2003, so probably they are bare metal. Does he have metal allergies?
Angioplasty.Org Staff, Angioplasty.Org, July 19, 2009

• My husband had two heart attacks in 2001 both times was stented. Ever since then he has episodes of allergic reactions. We know it is not from medications because he stopped all medications and still had the reactions. I don't know if his stents were medicated or not. He carries Benadryl with him all the time.
Gail B., Slaughters, Kentucky, USA, July 13, 2008

• RG -- there are a number of references on this Forum to patients with known or suspected allergies to nickel, a component of surgical stainless steel. All package inserts for stents, bare metal or drug eluting, contain language warning against implantation in individuals with known allergies to any component of the stent, and often specifies stainless steel and nickel, so this is not unknown. Perhaps an allergist can help.
Angioplasty.Org Staff, Angioplasty.Org, June 30, 2008

• I have an allergy to nickel. I was not questioned about metal allergies at the time of the first DES placement. Now I have a possible diagnosis of COPD. I am using a nebulizer and Advair as well as taking SINGULAR. I do have allergies but have not had so much trouble with my bronchi until Sept of 2007. I would like to know how allergic reactions to nickel manifest themselves. Could my breathing problems be caused by reaction to the nickel in the DES? And if this could be true what are the options? I know that DES placement is for life. My question then is how long will I live if I am allergic to the stents? I would appreciate some answers although I understand that this is not a forum for diagnosis. I am interested in any knowledge that can be provided. I do not know how or what to ask my dr. I am so worried that I am on anti-anxiety medication as well as 15 other drugs.
RG, Wisconsin, USA, June 24, 2008

• I am writing about my mother who is 60 years old. She has Heart Disease which is hereditary,Thyroid Disease and is a diabetic who has extremely high sugar readings between 300-500 on a daily basis. This is the medication that she takes:Insulin-Humalog 75/25, Metropol, Crestor, Plavix, Mirapex and etc. She had heart attacks which lead to having stents inserted, had a triple bypass surgery in between and yet still having to get more stents. Every 4 to 5 months, my mother's arteries become 90 to 100% blocked with having to get more stents everytime which none of the cardiologists can figure out why this is such a problem. Could you please tell me why this keeps occurring every 4 months? The stents implanted are the Taxus-Eluding Type of Stents. I know that my mother is allergic to the following medications:Keflex, Sulfa, Tramadol, Nitropatch, Glucovance, Glucophage, Glyburide and Provochol. She just recently had another heart attack on May 30, 2008 with found out the main arteries that were bypassed during her triple bypass surgery, are dead and cannot be utilized in the future. The explanation was that the triple bypass procedure was not effective. She ended up getting two more Taxus Stents on May 30, 2008 and now has a total of 10 stents. This moment, she is hospitalized again, but with a severe case of a rash/ hives, her skin is hot like a sunburn and miserable/ excessively itchy. The hospital keeps trying to counteract the hives with some Benadryl which is not working. The rash is reaching a critical stage and now I am wondering if the Taxus Eluding Stents are causing the adverse reactions that she is experiencing? What tests are out there that can be conducted to determine if this is the root of the problem or so I can rule this possibility out? She also was given Heparin -a blood thinner which she never had until May 31, 2008. Could Heparin cause an intensive rash and hives along with a burning sensation? Help I need some answers fast. Thanks.
Melissa, New Castle, Pennsylvania, USA, June 7, 2008

• Ken -- see our reply from May 20. Do you have allergies to metal? This is something that an allergist can test for.
Angioplasty.Org Staff, Angioplasty.Org, June 1, 2008

• 3 months ago I had a plain 316L stainless steel Boston Scientific stent placed in my right artery. I take lopressor12.5 mg twice a day, altace 2.5 mg once a day, Plavix 75 once a day, zocor 40 mg once a day, synthroid 50 micrograms a day, a multivitamin once a day and Darvocet N-100 as needed. I have developed a hyper sensitivity in my hands and feet that has lately been moving into my forearms that feels like my hands and feet are being rubbed across a screen or nylon stocking and I get this entire body feeling of tingling. It is driving me crazy and I'm about at the end of my rope on this, because my Dr. refuses to investigate anything, saying it's my nerves. I cannot get a new Dr. for special reasons. I am also getting a rash of pin point redness dots on my forearms that is now spreading. Could it be the stent? If so, can the stent be replaced? This is getting quite serious for me, please respond as soon as you have the time. Also, my teeth feel tingly when I brush them, just like my hands and feet feel. I'm begging for help. Thanks Much.
Ken S., Marshall, Minnesota, USA, May 26, 2008

• Jeannie -- the amount of drug that is given off (eluted) by these stents is pretty small, and pretty localized -- much less than the dose level you'd get when taking Taxol as an anti-cancer drug, for example. Which is not to say you're NOT having a reaction. But this is hard to pin down. Perhaps other meds? Many heart patients are prescribed new meds when they are diagnosed with CAD -- perhaps one of your blood pressure drugs needs adjustment?
Angioplasty.Org Staff, Angioplasty.Org, May 21, 2008

• I had a DES inserted into RCA April 4, 2008. I had a 70% blockage in that one artery. All others are 20-30%. I am a 61 y/o white female, retired RN. After the Cath, I came home the next day. Dr. told me to "go back to normal activities" the following day. I did. I normally walk every morning for 30 minutes before breakfast. I was very short of breath! felt terrible, Checked my b/p when I got home, it was 96/48. I rested. Same occurrence the next day. I called the cardio, he told me nothing he did could have caused decreased b/p. He was a little concerned about the SOB. I looked up the DES. Taxus 11 eluded [eluted] with Taxol and the side effects of Taxol. These included SOB, Hypotension. I asked cardio he said no...the eluding [eluting] process was minimal drug exposure. The SOB is minimal with exertion, hypotension continues in afternoons. I have since had EKG, Echo, Lab work to rule out clot. All OK. Possible allergic reaction to stent??
Jeannie Jeter, Summerfield, Florida, USA, May 20, 2008

• J.J. from UK -- here are some references to warnings about implanting stents in patients with metal allergies. The FDA warning is for all metal stents (bare and drug-eluting), not just the examples quoted here. The same language is in both the Instructions For Use (IFU) for the CYPHER drug-eluting stent (page 4) and from the Directions for Use (DFU) for the TAXUS drug-eluting stent (page 2): "Patients with a known hypersensitivity to 316L stainless steel may suffer an allergic reaction to this implant." and so on. The part of the stainless steel alloy that seems to cause the allergy is nickel. (Also, many metal surgical devices are made with Nitinol, a nickel-titanium alloy). The tricky part here is the phrase "with a known hypersensitivity." How such a condition becomes "known" is dependent on the patient communicating this knowledge to the physician. Patients are supposed to be questioned about allergies before a stent (or pretty much any medical procedure) but this query ("are you allergic to metal?") often gets lost in a long list of questions. Moreover, many patients may not be aware of their condition. Does this mean every potential stent patient should be given an allergy skin patch test?
Angioplasty.Org Staff, Angioplasty.Org, May 20, 2008

• Dear Forum -- Thank you for your support so far. I am still trying to find out the make of stent that my mother had fitted and also to convince the specialists that there is the possibility of metal allergies and stents. In your post of 5th May 2008 you referred to the FDA-mandated package inserts for All stents that urges caution against implanting stents in patients with known allergies to nickel and chrome. Could you please give me a reference for this info – i.e. a document on the web that I can research further and pass on to the specialists? My google searches so far have not been able to locate anything (this could be due to me struggling because of my medical ignorance!). Your support and advice is much appreciated. Many many thanks.
J.J., United Kingdom, May 19, 2008

• Thank you so much for your reply to my enquiry. Just this initial info that you have provided has given me the conviction to pursue the matter further (my Mother had again to visit the emergency Department of the hospital this week after suffering another trembling attack – the Doctor examined her for neurological causes ie a series of reflex tests which proved negative and they are investigating thyroid blood tests). I have contacted my Mother’s heart specialist and asked for details of the stent that has been fitted and have included details of your response which hopefully will provide some justification for exploring the possibility of an allergy. I will advise you of any response I receive. In the meantime I would once again wish to express my gratitude
J.J., United Kingdom, May 9, 2008

• The stent allergy study we are helping with concerns reactions to drug-eluting stents, most likely to the polymer plastic coating. From the description and history you sent in, it sounds like your mother has a known allergy to chrome, or other metals. Chrome dental clasps are actually an alloy of nickel and chrome. Nickel allergies have been well-documented. Most stents are made of surgical stainless steel which contains nickel. The FDA-mandated package inserts for ALL stents, bare metal and drug-eluting, caution against implanting stents in patients with known allergies to these metals. Sounds like the doctors are saying the stent was "plastic-coated". That would indicate a drug-eluting stent. Do you know the name or brand of the stent?
Angioplasty.Org Staff, Angioplasty.Org, May 5, 2008

• My mother, aged 75, has a history of angina and had a stent fitted on 9th June 2007, at Sandwell District Hospital. Since then she has spasmodically not been feeling well – her symptoms include sickness, headaches, trembling. The most recent of these “turns” has been today – she went to the hospital and had a full check on her heart including an ECG, blood pressure etc. The doctors assured her that her heart was fine. I have today started to research the possibility of an allergic reaction to the stent – we have on numerous occasions raised this with the Doctors but they have dismissed our theory. They say it is nerves, or rheumatism or age etc. The reason why we think it could be an allergic reaction is that my Mother’s symptoms are very similar to what she suffered some 15-20 years ago – it transpired that she had a reaction to a denture clasp fitting which turned out to be chrome – when this was eventually removed she recovered rapidly. Until that point she had suffered a general feeling of being unwell and unable to participate in activities etc. The doctors have said that the stent they have fitted is not metal but plastic coated – to what extent they are certain of this I do not know – but given that my Mother is susceptible to allergic reactions and I have discovered that some people do suffer even when it is plastic coated I feel it is worth pursuing this line of enquiry. Especially given the impact of the general feeling of constantly being ill is having on my Mother’s general well being and making her so depressed given that normally she is an exceeding young and active 75 year old. I would very much welcome any information/advice that you can provide. Many thanks.
J.J., United Kingdom, May 2, 2007

• Deborah and Niloofar -- as we've noted before, very little is known about hypersensitivity reactions to drug-eluting stents -- and one of the confounding issues is that patients with stents are also patients who take a number of different medications, each of which has its own set of adverse or allergic reactions. Also, because these reactions are small in percentage, it is very difficult (and expensive) to run large enough studies that will yield valid data. Two cardiology groups in Texas and Chicago are studying this (see "To Patients" notice in the right column). What they do is remove each medication (substituting a different one) to rule out drug reactions, and then do a skin patch test with small pieces of the various stents. If the skin reaction is positive, there is a high likelihood of allergy to some part of the stent (it is thought that the polymer-coating is the culprit). One option is to visit an allergist to see if a drug you are taking might be the cause. As for a fever and rash two years after stent implantation, probably unlikely -- and certain antibiotics are known to cause rashes in some people.
Angioplasty.Org Staff, Angioplasty.Org, May 2, 2008

• I have a problem that I haven't read here. I had 2 medicated stents inserted in Feb of 05. 10-12 days later I had several canker sores in my mouth. At the time I was 53 Years old. Before then I may have had 2 or 3 in my entire life. Ever since then I've repeatedly had 1 or up to 3 in my mouth. After it heals I get another. I am seldom without them. Is this some kind of reaction to the stent (or Plavix) or did I pick up something in hospital. Help!!
Deborah, Alabama, USA, April 26, 2008

• Greetings, My Dad is 82 years old and had two DES put in his heart, two years ago. Few weeks ago he caught the flu and a week after he was recovered, he had high fever for 24 hours and was put back on antibiotics, which led to having rashes. Could the rash and fever be a reaction due to the DES? I appreciate any feedback. P.S.: he is taking plavix, metoprolol, lipitor, flomax, Nexium.
Niloofar Yekani, Connecticut, USA, April 15, 2008

• Debbie and Sue -- we have sent you information about the stent hypersensitivity study being conducted in Texas and Chicago. if you browse around this toipic, you'll see a range of unexplained symptoms that patients have reported to us, symptoms that started after a stent was implanted. There are 4 possibilities:

  • reaction to a prescription drug started at the same time as the stent;
  • reaction to the drug-eluting stent itself (most likely to the plastic (polymer) coating);
  • reaction the the metal in the stent; and
  • reaction is unrelated to any of these and is coincidental.

Many patients report that their physicians believe this last explanation is the most likely, But given the number of postings here and the similarity in symptoms, we disagree and think that the last explanation is the least likely. Drug and metal reactions can be tested for by an allergist. If they don't exist then a possible explanation is a reaction to the drug-eluting stent. The study being done by the Texas and Chicago hospital does exactly this -- they eliminate other causes step-by-step and then administer a skin patch test, using a small part of an actual stent. They report to us that they are definitely seeing a correlation between positive patch tests, symptoms and inflammation at the stent site. The reason most doctors are unaware of this possibility is that there have been no studies published on the topic. The study we are involved in is the ONLY one of its kind, to our knowledge.
Angioplasty.Org Staff, Angioplasty.Org, April 11, 2008

• My mom had a Cordis stent put in in January 08. Immediately after she started to complain of intense pain in shoulders & arms & wrists. Her hands went numb & were so pained she would go days without sleep. Shortly after that both her knees blew up & were very painful. She is not able to get up from a sitting position. she is on Plavix. She was diagnosed with carpel tunnel in both hands & had surgery on one so far. The pain has subsided in that hand but not the tingling & numbness. Her cardiologist insists this is not relayed to the stent or the plavix. i am finding it harder & harder to believe. can you please furnish me with as much information as you can on side effects of medicated stents & plavix. i forgot to mention she took Vytorin for a month after surgery as well. My mom's health was great before this stent. I suspect she is rejecting it. Any help would be appreciated. Thank you
Sue, Florida, USA, April 5, 2008

• My mother had two stents placed in her heart in January 2008. She has had severe nausea EVERY DAY since then. She had congestive heart failure but never had any stomach problems before. The doctors have done many many tests and have given her every kind of medication. She is now on the medication given to chemo patients for nausea and she sleeps all the time or is very sluggish when awake. Her quality of life is GONE. We were not told of any side effects at all before the stents were put in. The doctors are very indifferent about this problem and act as if it is a total mystery to them and they have never heard of this reaction!! Please let us know what can be done!!!!!!!!!!!
Debbie N., Indiana, State, USA, March 30, 2007

• Brian -- hard to say, which is why we're sending you information about the drug-eluting stent study being done in Texas. One of the protocols is to take patients off of each drug (using an appropriate substitute) and once that's been done and the symptoms remain, they use a skin test to see if there might be a reaction to the drug-eluting stent material (not so much the metal, but the polymer/drug combo). Read our article "Drug-Eluting Stents May Cause Allergic Reactions" about a study published two years ago -- this is still a little-understood syndrome and, as newer drug-eluting stents come on the market, may change. Hope this helps.
Angioplasty.Org Staff, Angioplasty.Org, February 3, 2008

• I am a 45 year old male. On Dec 26, 2007 had one Taxus Express 2 drug-elating stent placed in the circumflex (which was 80% they also say I had a 100% that fixed itself). Upon discharge, I was placed on Plavix 75 mg., Metoprolol Succinate ER 25 mg., Lipitor 80 mg., Altace 2.5 mg., Ecotrin 325 mg.. all once a day. (prior to stent placement only meds I was taking was Lipitor 20 mg and Ecotrin 81 mg Once a day) Had no hypertension issues and cholesterol on Lipitor was about 140 (good cholesterol was a little low)

I informed the Cardiologist I was against such a raise in the Lipitor (from 20-80) he stated it was just for 2 weeks, well after 2 days I could feel the pains in the lower back and the legs, I called him and immediately put myself back down to 20mg. This was on 12/29/07.

Went back to work as Bus Operator on 1/10/08, everything was fine until 1/21/08, At the end of my shift, My arms, elbows, wrists, hands, fingers, knees, and ankles were very painfully swollen and sore. I had to go the the emergency room, they drew blood and told me it was probably an allergic reaction from the Altace (ACE inhibitor). The E.R. gave me an I.V. with Benadryl, Steroid and pain killer, went home 3 hrs later feeling fine. Stopped taking everything except Plavix and Ecotrin on 1/22/08. Stayed home until 1/25/08 went back to work and at the end of my shift, the same thing happened with all the same muscles and joints swollen and painful. Saw the Cardiologist on 1/28/07 he placed me back on the Metoprolol and lowered the Ecotrin to 160 mg. While still badly swollen, I saw my PCP on 1/30/08. He also agreed that this more than likely is a reaction from the ACE inhibitor He placed me on Prednisone 20mg and Benadryl 25mg once a day and return to Lipitor 20 mg. and lowered the Ecotrin to 81 mg.. This seemed to clear everything up. So I went back to work on 1/31/08 with the same results, at the end of my shift at night all the same muscles and joints became swollen and painful. I went back to my PCP and he raised the Prednisone to 60 mg. for 2 days than 40 mg for 2 days than 20 mg for 6 days. He also suggested that I change the Metoprolol to Coreg CR. I'm going to take the next 7 days off to rest the muscles and joints than try to go back to work.

I've been doing a lot of internet surfing in my free time at home, nobody seems to be definitely positive that it is the ACE inhibitor, The E.R. said it could take a couple of weeks for the ACE inhibitor to clear out, is this true?.I'm afraid it might not be. Could it be the DES or one of the other drugs (never had any problems with Lipitor) I been pretty healthy and active all of my life, playing racquetball once a week, mowing the lawn, swimming etc.. I'm new at this and quite concerned about what my next step should be if this problem persists. Help!!
Brian G., New York, USA, February 2, 2008

• A. Gregory -- aches and joint pains are a known side-effect of statins. You should discuss this with your cardiologist -- perhaps other methods of lowering cholesterol can be an adjunct.. Let us know what he/she recommends.
Angioplasty.Org Staff, Angioplasty.Org, February 2, 2008

• I have been taking Plavix, Hyazaar, Herbessor,Vasteral and Lipitor. I am a 58 year old female. I get a lot of aches and pains almost everyday but I need to get my Cholesterol down so I continue with taking Lipitor. Lovastatin also does the same thing but it does not lower the Cholesterol. In the long run is it harmful if I carry on with the Lipitor?
A.Gregory, Malaysia, January 29, 2008

• R.G. -- we can't give any specific medical advice, but you're definitely doing the right thing by meeting with your cardiologist about your drug regimen. Sounds like the statins might have been causing problems, but again -- this is something only your doctor should advise you on -- not us, or any internet site! We've definitely heard a lot from people with nickel allergies -- we've not found any medical literature definitively stating that this can cause serious reactions, but the cautions DO exist in the "Instructions for Use (IFU)" mandated by the FDA, so there must be some evidence.
Angioplasty.Org Staff, Angioplasty.Org, January 29, 2008

My list of medications include two statins atenolol, cozaar, Lasix, another blood pressure medication and 2 medications for acid reflux. I have just recently stopped the statins. The docs adjusted the statins down to an every other day administration. But I have felt so much better on the days that are absent the statin that I have taken an occasional extra day off of the med. This last weekend I decided not to take the statins (Zetia and Pravachol) and am able to get out of bed and have noticed less pain. I will be addressing this change with my physician. I was not asked about anything but medication or food allergies. I remember because on a later hospitalization I added nickel to my list. Statins are on the list. What are options for my predicament?
R.G., Wisconsin, USA, January 29, 2008

• Valerie -- stents cannot be "removed" once placed. But drug-sensitivity to Plavix is a known problem (rash, etc.). Read over our Forum Topic on Plavix and Stents. There is information there that may sound familiar. As for dealing with this situation, several groups have published papers on desensitizing allergic reactions to Plavix -- one in Iowa and also at Scripps in La Jolla. We'll soon be posting an exclusive interview with Dr. Karl von Tiehl of Scripps, lead author on a paper published in the November 5 issue of the Journal of the American College of Cardiology, titled "Clopidogrel Desensitization After Drug-Eluting Stent Placement". In this paper, which you might want to show to your cardiologist, Dr. von Tiehl describes the protocol for desensitization which, he tells us, is one which any qualified immunologist familiar with the area of drug desensitization should be able to carry out. If you or your doctor have further questions, feel free to post here, or even call Scripps. Good luck and let us know how you fare.
Angioplasty.Org Staff, Angioplasty.Org, January 29, 2008

• My dad (75, quadruple bypass 5 years ago) had angioplasty 3 weeks ago and had one DES put in for a significant blockage in 1 artery. He was put on Plavix but seemed to have an allergic reaction (itchy rash on chest) and was then put on Ticlid He's now experiencing a worse itchy rash. His cardiologist had said before there was no alternative to taking one of these 2 drugs for at least 5 months, that Coumadin and aspirin wouldn't work for this. How can we find out for sure if he's allergic to these medicines, or something in the stent itself, or maybe even the dye used in the angiogram? And if he is allergic to both medicines, what can be done? Remove the stent and put in a bare metal one? Another bypass?
Valerie M., New York, USA, January 29, 2008

• R.G. -- yes, pretty much all stents (drug-eluting AND bare metal) contain nickel and the FDA package insert / instructions for these clearly state that the device should not be used (or used with caution) in patients with known hypersensitivity to any componet of the stent. The tricky part here is the "known hypersensitivity" (a.k.a. "allergy") -- patients are supposed to be asked about allergies, etc. but we've found that many patients report not having been queried about this -- or they don't realize how important this information can be. It's also not clear as to how severe such a metal allergy can be (the stent is quite small). Are you taking other meds? For example, joint pain is a known side-effect of statins. But definitely see your cardiologist about your reactions -- he/she should be able to offer you some information and help. Let us know what you find out.
Angioplasty.Org Staff, Angioplasty.Org, January 20, 2008

• I wonder if I am allergic to Plavix? My symptoms include stomach upset, shortness of breath, severe pain in ankles and wrists. I am lactose intolerant and I have read that Plavix tablets contain lactose. I am allergic to nickel and I have read that taxus stents contain nickel. I would like to know if this is true and how should I approach the possibility of allergic reaction with my cardiologist or my family physician. I have had 4 stents placed in my RCA and D1 and continue to be semi bed ridden. What do you suggest?
R. G., Wisconsin, USA, January 18, 2008

• I am a 56 year old female that has recently (Nov.2007) had a Taxus Drug Eluting stent put in my LAD artery that was 99.9% blocked. I also had an angioplasty done on a smaller artery at the same time. I was involved in a car accident on Aug.11th, 2007, no fault of my own, this accident caused a major back problem that I was scheduled to have surgery on Nov.29th 2007. I began having chest pains, some worse than others, that concerned me enough to see my family Dr. He did an ekg, showed a problem, had a stress test which also showed a problem. My Dr. sent me to see a cardiologist in Joplin Missouri.He did an echo-cardiogram and found the problems. He never told me that my condition was life threatening, but he did tell my husband that the front part of my heart was barely getting any blood or oxygen to it. Had my heart work done on Nov.26th, 2007. the first thing I noticed immediately, was that my breathing was sooo much better!!! I felt wonderful until 4-5 days after my procedure. Then, all hell broke loose. I developed a itchy red rash like I have never experienced before! I still have scars where I scratched so hard. My Dr. gave my a 6 day series of a steroid pill which got rid of it. I guess I'll never know the cause of the rash, I thought it might have been the white contrast dye that was used to find the blockages. Since then, I have never felt better. My cardiologist was a gift sent from God, as I was so close to having a heart attack. Ironic, how an auto accident actually saved my life. I think the stress of the wreck is what started these angina pains, the pains are what made me get checked out. I feel like the Taxus stent has given me a 2nd chance at life. I feel great!!! Thank you, thank you, thank you to Dr. Robert Stauffer, Freeman Heart Institute Joplin Missouri.......
Norma Wilkes, Afton, Oklahoma, USA, January 14, 2008

• My name is Ken and I posted on this site in Oct/Nov of2006. In Aug 2006, I was given a cypher stent. I had 3 previous bare metal stents with no problem. I had refused the cypher stent, declined it in writing in 2004 when it was brand new, as I have a severe allergy to all Mycin drugs and their derivatives, This was clearly noted on my charts and records at the hospital and with my Dr. also on my allergy wrist band. 1 week after implant of stent I was readmitted with severe pain and blood pressure at 240/127. Re-catheterization showed the stent was still in place but during procedure I went into full arrest. Did I mention that I also have a pacemaker from 2005. I survived and wished that I had not. I lived with severe pain for several months and slowly regained some signs of life as the drug wore off. Problem came back in august 2007, and my NEW TEAM of specialists, did not feel that the stent was the problem. Back into cath lab and two more stents BMW were placed in to relieve recurring pain and weakness in left side. November I began to fail badly. BP out of control with any medications, back into hospital emergency room late november. Diagnosis was restenosis 95% or more in the medicated stent. Also showing some muscle damage to heart. Overworking? Bottom line on Monday 1/14/08 I will be back in again for bypass surgery to the blocked gx--ffd cypher stent. Never, Never Never risk a medicated stent. Be aware that Drs make more money using them and there is no way that I will ever believe that my first Dr was acting in my best interest. When I said no medicated stents I thought it meant forever. His lawyers argue no. With my other problems, I will survive this ordeal ONLY BY THE GRACE OF GOD... I TRUST IN HIM and No-one else. I did report this to the texas team doing the study and heard nothing. I wonder who is paying their bills. My bills for health last year $175,000.00 20% out of pocket.
Ken Feeley, Bonita Springs, Florida, USA, January 12, 2008

• Jackie -- the red rash is often a sign of allergy to a drug, usually Plavix -- but your aunt should NOT stop taking Plavix -- it's critical after stenting to stay on antiplatelet therapy to avoid clotting. One question: did your aunt begin any new drugs at the same time as the stent placement? These might be one cause, but she should certainly see her interventional cardiologist and discuss these symptoms with him/her. You might also email us at the address in the sidebar (under the "DONATE" button) to get some information on the stent allergy study being conducted in Texas.
Angioplasty.Org Staff, Angioplasty.Org, January 11, 2008

• I have an Aunt in Arkansas and she had drug eluting stents (6 months ago). She started the day she had them with vomiting, then she began to break out all over her body with a red rash and itching. She has been to all kinds of doctors and has continually gone down hill. She is very weak, has very low blood pressure. She was doing well until the stents were placed in her. She now has begun to have kidney and bowel problems. Do you know if she needs to go to an allergy doctor to find out if she is allergic to the stents or the medication in the stents?
Jackie, Millington, Tennessee, USA, January 8, 2008

• Plavix and Aspirin Resistance is another Issue. If the Plavix fed bleeding Ulcer don't kill ya then your dual antiplatelet the rapists oops (therapy) aint workin because as many a 1/3rd tested on such may be resistant to Plavix and aspirin see Accumetrics VerifyNow to get tested, Then ask your doc why he didnt test before.
stent clots x 3 and counting , realist, Florida, USA, January 7, 2008

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