Anyone have experience with stent or bypass? I will probably have one or the other
I had a stent placed 6 or so years ago. My cardiologist told me they would see if I could get by with only a stent during the catheterization. I told him I would not consent to bypass surgery, so if there was any chance for angioplasty/stent to go ahead.
I experienced zero pain during the procedure. I went home the next day and back to work (AMA) the day after that. I haven’t had any symptoms since.
I had an angiogram and they found that my arteries were too closed to admit a stent, so I’m having triple bypass surgery, now scheduled for Monday. I asked for experiences and also got some results about stents in this thread.
I expected to get a stent and was totally gobsmacked. Listen to what the doctors say when they get inside. Good luck.
I had a cardiac CT scan which is the newest thing and pretty sure it takes the place of angiogram. It showed the issues I have . Going to Dr Tuesday
I’ve had two stents. One went in through my wrist and the other ( 5 or so years later) was in the groin. Both were outpatient procedures and I was home the same day. For the one through the wrist, I was basically fine the next day. My wrist was a little sore, but that’s all. The other one, it took me about a week before I could walk without being in pain
The only reason I say angiogram rather than angioplasty is that the outcome precluded the stent, the “plasty” part. I suppose that if they know where the stenosis is located, an angioplasty can be considered a separate procedure, but I don’t understand how they could not know what the next step is if the cardiac CT scan shows the state of your arteries.
Of course, I Am Not a Rocket Surgeon.
From what I’ve read looking more like bypass for me. Trying to look at it as long vacation from work. but I know it won’t be easy .
No, not really. It’s lower risk than angiogram and can provide more info than other non-angiogram modalities, but the angiogram is still pretty much the gold standard to figure out what’s really going on with potentially plugged arteries.
so they will do angiogram to confirm what they saw on CT scan? And to make sure nothing was missed.
I had a stent placed after my heart attack about 15 years ago. They went in through my wrist.
They kept me for several hours afterwards because of the blood thinners/anti-clotting drugs in my system. A good thing too, as the bandage on my wrist got dislodged that afternoon and I bled all over the place until they were able to replace it. As soon as I was able to clot again they let me go.
I was awake for the whole procedure, with just a calming drug, and got to watch the monitor while they snaked the stent into place. It was fascinating.
Stent is definitely preferable, if possible.
I made a couple of posts in the thread referenced by @Exapno_Mapcase, most notably this one:
My situation was exactly the marginal case where either stenting or bypass might be feasible, but because the initial angiogram revealed more blockages (stenosis) than expected, I was sent back to my hospital room with a recommendation for bypass surgery. My rather strenuous objections led to a re-assessment and an agreement that stenting followed by a regimen of medication would be sufficient (though if I had been willing, bypass would probably have been marginally better).
I got the stenting as an in-patient only because I was already there following a mild heart attack. It’s sufficiently non-invasive that it can be done as an out-patient procedure. As with everything else, there are pluses and minuses and there are risks. I was informed that, as non-invasive as it is, the stent placement procedure can potentially trigger a heart attack (very unlikely, but it’s possible). It’s also possible to accidentally puncture an artery (also very unlikely, but possible). But overall I think there are more risks in full open-heart surgery, and certainly a more difficult recovery.
I got a stent in the LAD July 2019. They said before the procedure that if they were to find multiple severe blockages I would be a candidate for bypass. They did an angiogram to diagnose and found a 90-95% blockage in the LAD, and other lesser blockages that didn’t need treatment. Then they did the stent. It was not a general anesthetic but I don’t remember anything once they got started. The worst part of the whole thing was they kept finding reasons to wake me up so I was exhausted the next morning. I spent Tuesday night in the hospital for observation, went home Wednesday, was on a plane to France on Saturday.
To make a long story short I nearly had a heart attack in the cardiologist’s office during an echocardiogram and they sent me right the ER, so all of this happened without a lot of time to mull it over.
Cat scan shows my blockages around 50% so maybe I can get a stent.
My father got a double stent when he was over 90. They wanted to do one because they feared that putting him under with a general would be bad for his brain. It seemed to work fine. He lived for another five years with no more heart attacks.
I got 3 stents in 2019. Two separate procedures one wrist, one groin. Neither was painful and I was awake* during both and talking to the cardiologist/surgeon. And could actually “feel” and point to the catheter thing moving in my chest.
The only downside was I (apparently) coughed and partially dislodged the plug** in my femoral artery immediately afterward.
In my case I was on blood thinners for 18 months following the procedure. Warning: this medicine is frightfully expensive, almost $300/month.
I was quickly up and about with only Doctor-imposed limitations following both. The recovery was remarkable and I felt better (than before the procedures) within days.
*according to the cardiologist later – I don’t remember much
**I awoke from anesthesia to nurses/techs rushing around in earnest, massive pressure on my inner leg, and people shouting in medicalese. I gathered from the context that “stat” means “hurry”, but didn’t learn much else. I got to spend most of the day in recovery and being watched over pretty carefully. The first time I was home by lunch, but this second time arrived home after dark. The bruises in that area were ghastly and lasted for weeks. Oddly, there was no pain beyond the heavy pressure on my groin/femoral area. Whoever was tasked with that took their job seriously.
Do you recall what drug you were on? I was on Plavix and aspirin for a year, but IIRC Plavix was cheap, in line with my antihypertensives.
Plavix is available as a generic so that is likely why it’s cheap now
Yeah, I was on clopidogrel, just used the name Plavix since it is more recognizable.
ETA: also, thinking back, I was purchasing my meds online at the time with my PCP’s blessing, although the legality was questionable.
A more accurate translation would be “right fucking NOW!”.
What is it that kicked off your original question? This is definitely a conversation with your cardiologist. I got a stent in an LAD that was 90-95% blocked. I had blockages of up to 60% in other arteries but they said that was not enough to put in more stents. I was surprised. Different doctors may take different approaches.
It’s good for you to collect experiences here but it sounds like you need a lot more information from your doctors.