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Interventional Cardiology (Expert Forum)
Options after in-stent thrombosis?
Answered by
Truman Medical Center
MO
Questions in the Interventional Cardiology forum are answered by medical professionals affiliated with the Truman Medical Center. Topics covered include acute coronary syndrome, angina, atrial fibrillation, cardiac catheterization, cardiomyopathy, drug abuse & cardiac disease, echocardiography, heart failure, hypertension & heart disease, lipid management, minorities and heart disease, peripheral vascular disease, prevention, valvular heart disease, women’s heart health, and the warning signs of a heart attack.
Options after in-stent thrombosis?
by hsc, May 21, 2008 03:14PM
Hi,
My father had an angioplasty with stenting 3 months ago.
One of the stent was drug eluting, while the other was a Bare metal stent.
He developed acute angina a week ago and was hospitalized.
The angiography revealed that here was a blockage in the drug eluting stent while
the BMS was fine. According to the cardiologist, there was a 50% thrombosis
in the DES.
He was prescribed tirofiban while in the hospital and doesnt have any angina symptoms
at this moment. The doctor says that its because the blood thinners have probably
dissolved the clot.
My father was on plavix all this time, thus is the diagonosis of stent thrombosis
accurate?
Can this be a restinosis and not a thrombus, How easy is to distinguish
one from the other.
Also how likely is it that the blood thinners caused the lysis of the thrombus.
What are our options at this point.
Thanks
HSC
My father had an angioplasty with stenting 3 months ago.
One of the stent was drug eluting, while the other was a Bare metal stent.
He developed acute angina a week ago and was hospitalized.
The angiography revealed that here was a blockage in the drug eluting stent while
the BMS was fine. According to the cardiologist, there was a 50% thrombosis
in the DES.
He was prescribed tirofiban while in the hospital and doesnt have any angina symptoms
at this moment. The doctor says that its because the blood thinners have probably
dissolved the clot.
My father was on plavix all this time, thus is the diagonosis of stent thrombosis
accurate?
Can this be a restinosis and not a thrombus, How easy is to distinguish
one from the other.
Also how likely is it that the blood thinners caused the lysis of the thrombus.
What are our options at this point.
Thanks
HSC
Doctor's Answer
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We are facing another issue at this time.
We are having a difficult time controlling his blood pressure. We are observing that it becomes higher during the morning hours when it reached 160. This caused him to develop angina again.
He is taking 5 mg ramipril in the morning with 2.5 in the evening.
In addition his is also taking Lasix which was prescribed for a period of 2 weeks.
Should we continue to take Lasix. Is the dosage of Lasix conflicting with the Ramipril in any way. Please advise.
Thanks