Stents and Blood Clots

[jawhaler]

Is it likely that having  a stent placed in a heart artery could cause a blood
clot later-- weeks or months-- in the same leg in which the catheter is inserted,
or either leg?

[anandbharti]

I always ask the hospital for a copy of all my reports including the CD of the catheterization procedure. I also make many copies of the CD so in case I need second or third opinion, I can leave a copy with the doctor concerned. In USA, patients have right to have access to information and so hospitals are amenable to making a CD for you. I never had any problem uploading the CD on my computer and watching my own heart.

Good luck.

[anandbharti]

Thanks for sharing  the symptoms of a leg clot. I have  muscualar pain in my hips and thighs, as mentioned earlier, however, there is no swelling. Nevertheless, I am getting a Doppler scan done this Saturday.

I hope your recovery from now as "uneventful" as the say in medical lingo.

As to your question regarding "one stent at a time" to Ed34, I believe it is a simple matter of making the most money out of a patient. Eight years ago, I made three visits to a hospital in New Jersey. First for a diagnostic angiogram and two further visits for a stent each. Two weeks ago at a different hospital (still in the NY/ NJ metro area)  they did the diagnosis and fixing (putting the stent in) at the same time. Incidentally, eight years ago, the stents failed within weeks, gave me a significant MI and need for a bypass.

Take care

[ed34]

To make clear what im saying, watch this video of a angiogram. Notice how the artery shows up then quickly disappears when the dye flows away, then more is injected.

http://www.youtube.com/watch?v=Eoq9yrT-Ejk

[ed34]

"But doesn't
the iodine medium circulate throughout the vascular system once it is in there-- so
that it would actually be better to have had the second stent done at the same time,
rather than have more iodine contrast next time?"

Yes but it becomes too diluted within seconds and the image becomes very unclear. Fresh idodine dye is frequently squirted out of the tip of the catheter to maintain a clear image.
Imagine you are looking at the LAD. You squirt in some constrast, this flows out the LAD through smaller branches, through the capillaries, and eventually ends up in the right Atrium for returning to the lungs. So, the dye is always running away from you.

[ed34]

The precision is quite easy because the scale of the blockage is actually seen on the angiogram. You can see the vessel in front of the blockage and how much blood is managing to pass it.
I was on the table for 3 hours when they put 5 stents into my LAD. Different people react in different ways to the dye used and the signs are seen on your obs shown on the monitor. The last thing they want is for your heart to start going into A-fib during the procedure, especially if they are carefully trying to line up a stent. I went into a-fib after the treatment. I remember going very light headed and my heart was racing at over 200 bpm. I was injected with strong meds to knock me out and given a shock to contract all the heart muscle at once, resetting the electrical signals through the chambers. I'm glad I only needed the one mild shock and that it worked. Statistics say it works in around 90% of cases. If your other blockage was life threatening then of course they would have treated this first. I believe the dye is filtered out of the body in approx 24 hours.
Mild allergic reaction is usually felt as a warmth and this is very common. It is also interesting to note, there is no test to define if you are allergic to the iodine prior to the procedure, skin tests have proved false.

[jawhaler]

First, there were symptoms-- my leg was swollen ankle to groin, about 50% larger
than its normal size.  Thinking this was related to the stent I had received, I went to
the cathlab, where they did a doppler ultrasound which revealed the clot.  I was put on
intravenous heparin immediately,  and remained in the hospital for 6 days.