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How to ensure long term flowability through artery implanted with Bare Metal Stent(BMS)

I have a bare metal stent implanted in my LAD following MI. My LCx is also 100% blocked but is getting blood supply via RCA and now opened LAD. My EF is 30%. Now eight months have passed since implantation of stent. A repeat angio four months after stent implant showed no restenosis. So far it does not look like as if I have problem. But having gone through literature and from some of the responses in this forum, it appears that it is only matter of time that restenosis will take place. I am taking clopidogrel and asprin daily. I also take beta blockers and ACE-I.

I am worried that if restenosis take place I may have another heart attack which I may not survive.

Does anybody know what precautions I should take and what tests(and how frequent) I should go through to find the problem in advance??  In case restenosis is going to take place anyway, what action need to be taken to ensure that my artery remains open??

Thanks in advance.
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Avatar universal
I don't think that there's anything that you can do to prevent restenosis.

At the same time, if you're good after 8 months, you probably won't have a problem.  At least that's my understanding of it.  Mine re-clogged within 2 months of installation.

If you do a stress test or similar, it should indicate a problem.  I do mine annually.
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Avatar universal
I don't see a statin listed as one of the drugs you take. If you don't get to the root of your problem, you will continue to block and not just at the stent. When your arteries have  >70% stenosis, the disease is everywhere. There was one study where people who took 40mg of Crestor for 2 yrs showed great improvement in their disease. The other drugs you are taking will help your heart recover, but don't do much to prevent restenosis. Good luck ! Go to PBS.org and watch "the hidden epidemic" It is a wealth of heart info.
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Avatar universal
Jim62 and E.r.boy, thanks for your responses.

Jim, did you have a bare metal stent(BMS) or coated one?? After restenosis did the problem occur again?? Does it mean that BMS will have problems anyway and I need to be going to hospital to get new stent after some intervel. I am just trying to figure out how people go about it??

E.R.Boy, the medicines I am taking includes statins, clopidogrel, asprin, beta-blocker and ACE-I. I was under the impression that blockage due to CAD and restenosis in stent are two different phenomenon. I thought CAD is due to deposits on account of lipids for which I am taking statins, low fat diet and exercise. Restenosis was a development, not dependent on lipid profile but activated by installation of stent. Now it looks like controlling lipid profile can keep the restenosis away, which I am already doing. Please can you educate me more on this.
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Avatar universal
I think you are right about the restenosis being a whole different problem.  Problems with stent restenosis are brought on by the installation disturbing the artery wall, and the body responds by attempting to repair what it perceives as a problem.  In some cases it overdoes the "repair", and the inside of the stent is filled with the material that is supposed to be doing the repair.  It is much like scar tissue that forms when any kind of wound heals.  Sometimes it heals just fine and other times, we wind up with a big ugly scar.  I don't think that any medication or diet or anything else will have any effect on it.  On the brighter side, usually a problem will show up within a couple months, so I'd say that you're out of the woods on that one.  I think the restenosis rate for bare metal stents is something like 25% or thereabouts.

I had 3 bare metal stents installed in 2003, and within 2 1/2 to 3 months they clogged.  I had the same symptoms then as I had with the original blockage, chest pain, etc..  They decided that I needed bypass surgery rather than more stents or any other procedures.  Interesting thing is that the bypass surgery did not deal with the arteries where the 3 original stents were placed.  They bypassed 3 other areas.  There's a lot that I don't understand about the whole deal.  There was NEVER any discussion about what the problems were and what could or should be done to fix them.  The doctors just said what they were going to do and that was the end of the discussion.  Of course being a novice heart patient, I assumed that they knew what they were doing, and what really needed to be done and just agreed with whatever they said.  After a lot of study on the subject (after the fact), I feel that I was very likely vastly overtreated and/or mistreated.  Probably would have a real good malpractice case.  BUT, heart problems are another one of those things that are open to speculation.  I was in excellent physical shape when mine started--good diet, exercise, etc. etc. etc., ad nauseum.  If you question the whys of it all, a cardiologist will reel off the old "if you weren't in such good shape, you might be dead" routine.  Could be, I guess.  If I stepped off the curb in front of a bus, I may be dead, too.  Anyway, it's the nature of the beast.  Some people get it and some don't.

Good luck with that stent.  As I said, I figure you got it made on that deal, after 8 months with no signs of trouble.  Don't worry about "might happens".  Go on about your life like an ordinary humanoid--if there is a problem, you'll be the first to notice something.

Be of good cheer.
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Avatar universal
What a relief. But sorry about what you have gone through with your stents. You are right and specifically in case of cardiologist they always keep some information with them which you are not aware of and come to know about it when some problem comes. May be it is linked to nature of this disease. In fact one of the forum members wrote to me that blokage in arteries(unless you come with heart attack) can be managed by three methods: bypass, stent and medications(only). And all three are equally effective. He mentioned a study which concluded this. I hope the worst part for you is over. I hope the problem of restenosis has not activated in my case and will not come up.

Thanks for sharing the information. Good Luck.
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