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Is it catch22: Stents vs Balloons

Posted: Sat Mar 20, 2010 2:57 am
by adamt
After reading lots on CCSVI and the liberation procedure it looks like having Stents or Balloons is catch 22:

You have Stents: Risk of stent migration = heart failure/attack

You have balloons: Risk of restenosis = travelling back to Poland for them to put stents in instead!


So im quite confused what to request when i have my procedure.

It seems like Catch22, you pick the mpost efficient way (stents) and there is a huge risk, or you pick the safer but less sustainable choice (balloons)

What does everyone else think about this?

Posted: Sat Mar 20, 2010 3:24 am
by eric593
I'm not sure doctors are offering patients the choice. I believe doctors are going with their own medical opinion on what is the best option to try given what they find. Doctors appear hesitant to try stents at first instance unless they are reasonably certain that angioplasty will most likely not be successful. I don't know if the patients are given the choice to decide what they want themselves, doctors are making the decision based on their experience and expertise in this area.

Posted: Sat Mar 20, 2010 3:29 am
by adamt
eric593 wrote:I'm not sure doctors are offering patients the choice. I believe doctors are going with their own medical opinion on what is the best option to try given what they find. Doctors appear hesitant to try stents at first instance unless they are reasonably certain that angioplasty will most likely not be successful. I don't know if the patients are given the choice to decide what they want themselves, doctors are making the decision based on their experience and expertise in this area.
oh i thought the patient had the option of deciding.
but yeah that does make sense for the surgeon to decide when he has examined the stenosis

Posted: Sat Mar 20, 2010 3:41 am
by Lelo
Absolutely right Eric. We were four liberated the same day. Everybody had different problems and the doctors (in Poland )now what they are doing. It´s not a guessing game. But if you would not like a stent they not forcing you, and do the balloning instead. But my descision was to do what was needed to be done. One stent in jugular and waiting with stent in azygos (not so much reflux there). Not complicated, but the doctors advice was to wait couple of months and see if I´m satisfied with improvement.

Posted: Sat Mar 20, 2010 6:42 am
by Donnchadh
My IR gave several very well thought out reasons for not implanting a stent. First, and most importantly, the location of my stenosis was in a very tight spot: not much space between the skull and the skin. He also mentioned that stents are capable of between 40,000 and 50,000 flex's before they might break into pieces, and that area involves a lot of motion. Lastly, if the stent had to be removed, it might involve surgery. Now that the exact location of my stenosis has been determined, if the veins relapse he will know right where to go.

Donnchadh

Posted: Sat Mar 20, 2010 12:02 pm
by Cece
Donnchadh wrote: He also mentioned that stents are capable of between 40,000 and 50,000 flex's before they might break into pieces, and that area involves a lot of motion.
This is good information. They'll come up with the a better sort of stent, it just isn't out there yet...and I hope my issues can be fixed with ballooning alone, I want this to be over!!