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Non-cardiac surgery after Taxus Stent and Plavix

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MedHelp Member's Question
Non-cardiac surgery after Taxus Stent and Plavix
by rjforsythe, May 27, 2005 12:00AM
How soon after getting a Taxus stent and going on Plavix can a patient get off Plavix in order to have additional surgery?  My mother-in-law has recently had a Taxus stent put in and is on Plavix.  Her cardiologist insists that she stay on Plavix for at least a year before any other surgery.  She is in desperate need of a hip replacement with bone-on-bone and is barely walking.  We do not want her to lose the ability to walk and want to remove her pain and get her off the powerful pain drugs.  We plan to have her do the less-invasive hip surgery so the recovery time and the opening for the replacement is small. If we schedule this for 6 months after the stent was placed, and get her off Plavix and back on it as soon as possible after the hip surgery, would this work, or do we need to wait longer for this type of stent to do its thing and get the endthelization completed, since it takes longer for these stents?  I should also mention that she has a pacemaker/defib and seven other bare metal stents from a previous heart attack, and one artery totally blocked currently.  We obviously don't want to take a huge risk of thrombosis with doing her hip, but she has been in so much pain for years with the hip that we really want to get this done and get her more mobile and in better health and spirits.
Doctor's Answer
by CCF-M.D.-MJM, May 27, 2005 12:00AM
Hello,

The data on drug eluting stents like the Taxus stent is still coming in.  We do know that people that stop plavix prematurely are a great risk for in stent thrombosis and heart attackss.  Although the answer may vary from case to case, in general we recommend that patients stay on Plavix for at least one year after a drug eluting stent.

This may not be the answer you want to hear, but we have seen many acute thrombosis with in days after stopping plavix -- I would not advise stopping early.

I hope this helps.  Good luck.
Related discussions
Member Comments (9)
by chrisr, May 27, 2005 12:00AM
How new is the drug-eluting Taxus stent? I had a Cypher RCA stent implant in PR about 2 months ago but decided to go to a Miami hospital after chest symptoms persisted. There I was told the Taxus stent was better and the norm so I signed onto a researh form for another implant with the Taxus. Unfortunately the artery (LIMA bypass) through which it was inserted went into serious spasm and also was told that this does occur sometimes. But I am now wondering whether this was indeed a side effect of the Taxus stent and I was the guinea pig?? I still do have chest discomfort over 2 weeks post-implant and unaware if the Taxus stent is open and doing its job? I apologize for butting in with a smomewhat unrelated topic but never could get through to posting. With no improvement, frustrated  and not knowing what to do from here I would greatly appreciate comments from anyone with a similar condition.
Thanks in advance,
ChrisR
by chrisr, Jun 12, 2005 12:00AM
To: Al
Hello Al, Thanks for your comment on the Taxus stent with spasm complications. How are you doing now? Do you still have chest pains and/or discomfort? A Cath 2 weeks ago also showed my stent all clear and they went ahead and implanted another for another blockage. Although there were no spasm complications this time I do have little appetite and some extra palpitations? Did you ever experience this after stent implant and what medications helped? Sorry for the delay in replying but I had to travel back to Miami for this latest procedure and only returned home yesterday. If you wish you can contact me directly at ***@**** and Iwould again appreciate any comments you can give since I never seem to be able to get through with a question to CCF.
Thanks again,
Chris R
by cyberlord, Jun 16, 2005 12:00AM
Just had three Taxus stents placed in the circumflex.  Had 3X CABG 4 years ago.  Two of the three bypasses did not take.  Wondering if the drug paclitaxel on the stent is a good thing when three stents are placed in the same artery?
by lnw2006, Aug 04, 2005 12:00AM
My question is regarding a family member who has had 3 drug eluting stents placed in the heart approximately 4 weeks ago.  He is currently being anticoagulated with Plavix.  Now he has been found to have a non-functioning gallbladder that requires surgery.  His liver enzymes are elevated.  He is vomiting bile.  The general surgeon communicated with the cardiologist who informed him the patient is not stable enough to have surgery only 4 weeks out from the stent placement.  Since the 2 doctors have communicated the patient has been taken off Plavix and placed on Heparin SubQ.  

What are the risks if surgery is or is not performed?  It sounds like either way this is a catch 22.  Can you help me or guide me to the correct references to read literature about this?
by mrdennis, Aug 29, 2005 12:00AM
thats a question i would like to have answered also..I was supposed to meet with a surgeon about possibly having gallbladder surgery and next thing I know I am at the hospital with chest pains ( I have been through this before) and my heart doctor put another stent in my heart,,no. 5  ...But meanwhile I am still having severe stomach pain. What is a person supposed to do???
by mmehrezz, Sep 18, 2005 12:00AM
How soon after getting a Taxus stent and going on Plavix can a patient get off Plavix in order to have additional surgery? My father has recently had a Taxus stent put in and is on Plavix. His cardiologist insists that he stay on Plavix for at least six months before any other surgery. He is in desperate need of a total knee replacement and is barely walking. We do not want him to lose the ability to walk and want to remove his pain and get him off the powerful pain drugs.  If we schedule this for 6 months after the stent was placed, and get her off Plavix and back on it as soon as possible after the hip surgery, would this work, or do we need to wait longer for this type of stent to do its thing and get the endthelization completed, since it takes longer for these stents? I should also mention that she has a pacemaker/defib and seven other bare metal stents from a previous heart attack, and one artery totally blocked currently. We obviously don't want to take a huge risk of thrombosis with doing her hip, but she has been in so much pain for years with the hip that we really want to get this done and get her more mobile and in better health and spirits.
by THE CURMUDGEON, Sep 19, 2005 12:00AM
I'm 4 day out from my first Taxus Stent. They have me on Plavix, Coreg, and Caduet. What should my expectations be? Should I have palpatations, chest pain? Should my BP drop to Normal (120/70)?
by mmehrezz, Sep 21, 2005 12:00AM
How soon after getting a Taxus stent and going on Plavix can a patient get off Plavix in order to have additional surgery? My father (79 yrs) has had a Taxus stent put in 3 months ago and has been on Plavix since. His cardiologist insists that he stays on Plavix for at least six months before any other surgery. He is in need of a total knee replacement and is barely walking. We do not want him to lose the ability to walk and want to remove his pain and get him off the powerful pain drugs. Is it safe to have the operation performed 3 months after the stent has been planted?
by Kurtis, Mar 27, 2008 11:23AM
A related discussion, Plavix was started.
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