I suspect that there is more to this than the need for stopping Plavix before surgery… Stent placements are not light-weight surgeries and the body will experience the procedure as a trauma –this is going to reduce the overall effectiveness of the mind/body system for a while and increase it’s vulnerability….
From the article:
“The high observed incidence of serious complications after post-stent surgery ought to make you and your doctor take notice.”
Recent Stent Makes Non-Cardiac Surgery Much Riskier
Richard N. Fogoros, M.D.
May 6, 2011>
A study appearing recently in Circulation: Cardiovascular Interventions shows that patients who have recently received coronary artery stents – either bare metal stents or drug-coated stents – have a much higher risk of cardiovascular complications if they have non-cardiac surgery up to a year after stent placement. The elevated risk is especially prominent for the first six weeks after stent placement.
Investigators from Edinburgh, Scotland studying data from the Scottish Coronary Revascularization Register, found over 1900 patients who had received stents and then went on to have non-cardiac surgery (such as orthopedic procedures, cosmetic surgery, or gastrointestinal surgery). They found that, whether the stents were drug-coated or not, serious cardiovascular complications – including heart attack or death – were seen in 42.4% of patients if the non-cardiac surgery was done within six weeks of stent placement, and in 14.5% of patients if surgery was done within one year.
While the precise cause of this increased risk is not fully known, presumably it has to do with the need to stop therapy with Plavix and other “blood thinners” in order to do the surgery, which may allow blood clots to form on the stent, thus blocking the coronary artery.
The investigators point out that their study is relatively small, and it is also a retrospective study, so it will likely not lead to a change in official guidelines about stent placement and surgery.
Unless your proposed stent is being placed on an emergency or semi-emergency basis (that is, in the treatment of acute coronary syndrome), you and your doctor need to fully discuss any foreseeable need for surgery during the next year, before deciding on whether a stent at this particular time is the best option.
Since the need for subsequent surgery is not always predictable, this new study should be one more reason for you and your doctor to have a long talk about all the options for treating coronary artery disease, and not defaulting immediately to stents.
{ 2 comments… read them below or add one }
hello,my husband had stent placement before a surgery for a blockage of the intestines. He has been a right hemiplegic for 17 years because of an AVM in an inoperable part of his brain. it bled 3 times before the science caught up with him and the Proton beam therapy closed off the AVM.He also has small dense LDL factor which caused his arteries to block. The blockage in the intestines turned out to be vascular in nature ,which is a whole other can of worms. I would like to know how long after the intestinal surgery should he have been put back on blood thinners.shouldn’t a patient with these issues be kept in CCU until the blood thinners are reintroduced? They kept asking me if they could move him to a regular floor that had distance telemetry. Their stepdown unit was full .I refused to let them move him . He was moved when I left for the night. He called me at 5am and said he was in intense pain and that he was in a new room and new floor he was in trouble a young inexperienced LPN was in charge of him. When I got there I was obvious that he was having a heart attack. I ran to the nurse station asked for his nurse told them to call his DR. and that it looked like he was having a heart attack. I checked in the telemetry room and the teck there said his stats were fine. I went back to his room and found the telemnetry leads were not all hooked up the inexperienced LPN said that would not make any difference. When the nurse re-attached the leads ,alarms must have sounded because a nurse ran in with a EKG machine then popped nitroglycern and aspirin in his mouth and then he was rushed back to the CCU to wait for the cardiac cath unit to assemble a team. Yes ,Thats what I said.I was told he had had an acute MI. He is home and getting better.But I would like to know IF EKGs on him would read normal after 3 weeks. The Dr that did the cath said the EKG was perfectly normal at his follow up visit . Small dense LDL is looking more and more to be a major player in CAD . Why do DR.s look at me funny when I ask about it?
Ms. Webb:
Sorry that I can’t give medical advice on this blog… My own experience is that medical care is very uneven, and depends very much on the individual qualities of the doctors and nurses …( I have personally found the Mayo Clinic to provide exceptional care in most situations…)
you might consider finding a forum out there and perhaps some other folks have some thoughts about what you and your husband have been through….
one that I am familiar with is –
https://www.inspire.com/groups/womenheart/