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Anticoagulants very important for Stents but Not for Balloon

Posted: Mon May 31, 2010 8:48 am
by adamt
Hi,

I hear of anticoagulants being very important for patients who have stents, but few have them with balloon angioplasty.

Why is this?

I thought ANY surgical incision/intervention would need anticoagulants to prevent clotting?

Could someone explain please

Re: Anticoagulants very important for Stents but Not for Bal

Posted: Mon May 31, 2010 10:00 am
by dodgeviper
adamt wrote:Hi,

I hear of anticoagulants being very important for patients who have stents, but few have them with balloon angioplasty.

Why is this?

I thought ANY surgical incision/intervention would need anticoagulants to prevent clotting?

Could someone explain please
A guess from a non professional:

The stents are metal and not native tissue. The stents are not smooth like the normal interior of veins but are stretched mesh. When the body's natural mechanisms detect something not smooth (like a foreign mesh surface) the "repair injury" response comes into play: clotting around the injured site.

When you only have ballooning no foreign material is placed into the vein and the ballooned, stenosed area is like the rest venous system: smooth and natural.

While there might be other reasons for taking anti-coagulants if one has been "only ballooned" the reason for taking them when having a stent is stronger.

Again, guesswork. So don't shoot.

Re: Anticoagulants very important for Stents but Not for Bal

Posted: Mon May 31, 2010 10:36 am
by Cece
dodgeviper wrote:When you only have ballooning no foreign material is placed into the vein and the ballooned, stenosed area is like the rest venous system: smooth and natural.
My understanding, garnered only by reading 100+ pages in Dr.S's thread, is that when a vein is ballooned, it causes injury to the vein. This injury spurs an "intimal hyperplasia" response of regrowth which can lead to the vein clotting off. I think. If intimal hyperplasia and clotting are wholly separate things, then I've misunderstood it along the way. So in my opinion because it is in DrS's opinion and because he makes a good argument, with anticoagulants the benefits outweigh the risks even in ballooning-only situations. He performed just 20 or maybe 19 balloon venoplasties and experienced clotting complications in at least two that he has mentioned. In one of those, he was unable to unclot it or declot it once it was clotted, so that venous route is still not open in that patient.

Posted: Mon May 31, 2010 1:45 pm
by adamt
thanks for the replies.

So i guess i better demand anticoagulants post procedure.

How long is suitable to be taking the anticoagulants for after being liberated?

Is Heparin theb est choice anticoagulant?

Posted: Tue Jun 01, 2010 6:58 am
by tzootsi
adamt wrote:thanks for the replies.

So i guess i better demand anticoagulants post procedure.

How long is suitable to be taking the anticoagulants for after being liberated?

Is Heparin theb est choice anticoagulant?
I'll try and answer this, since my wife had balloonings on both jugulars about 7 weeks ago - no stents. She was put on Plavix for a month. She had a doppler checkup after one month, and everything looked good. She is now on a daily baby aspirin, at least until her next checkup in August.
Realize every case is unique, and different doctors may have different recommendations.

Posted: Mon Jun 07, 2010 4:44 am
by TMrox
I was put on innohep for a month after the balloon angioplasty. My vascular surgeon said that it was really really important that to have the this med to prevent blood clots.