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Had A Coated Stent Put In, Stent Go Re-plugged. What Is This Junk That Plugged My Stent?

Posted on Tue, 11 Sep 2012

Question: Had a coated stent put in, XXXXXXX / 2011. Just had angio surgery Monday, just seven months later. The Doc said the stent had re plugged, not with scar tissue, but, as he said, a bunch of junk. What I don't get is why? I've lost 30 lbs, dropped cholesteral and trigl's way low, walked 3 miles a day, ate right; in essance, did everything right. So, he just opened the vessel; no new stent. What then, could this "junk" that re plugged my stent up be and how do we approach taking meds, vitamins, etc; to keep this "junk" from sticking to/in the stent again - Red wine/ day? Thanks',
My cardio doc suggests Folic Acid? I've done some research; Perhaps this would lower the root cause trouble maker? Suggestions? Also, how about the Omega 3's? Yes or no? Would the vitamins interfere with my med's? Thanks. XXXXXXX.

Answered by Dr. Rakesh Madhyastha (1 hour later)

Hello

Thanks for the query

You have done well by following a strict diet and also losing weight.
But I would like to point it out to you that even if you are doing the right things atherosclerosis (junk) will take place but maybe at a slower pace.
If you had not done these things atherosclerosis would have taken place faster. So please continue your diet control and exercises.

Folic acid has been prescribed for slowing down atherosclerosis, omega 3 fatty acids are more useful to improving high density lipids if at all they are less in you

I hope I have answered your query, if you have more doubts I would love to clarify it

I wish you good health

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rakesh Madhyastha (4 hours later)

Thank you. But..... Can a vessel plug up in just 7 months time? What is the makeup of this junk? If cholesteral is just part of the plaque, what else can be lowered or made non sticky?It took 54 years for the 1st blockage! My cholesteral numbers are way low and this is the only vessel in my body with this problem. Am I to expect a heart XXXXXXX twice a year/

Answered by Dr. Rakesh Madhyastha (15 hours later)

Hello,

Thanks again.

I understand that you would be a concerned man after having to undergo repeated procedures. So let me answer your queries this way.

1. A vessel can get plugged in 7 months. It is not impossible though you have done everything right to prevent such occurrence. I have seen vessel getting plugged within 3 months in some patients.

2. The junk mainly contains endothelial cells, products of inflammation and lipids. Lipids though are predominant in most cases.

2. Folic acid was given along with lipid lowering agent to reduce the other products that form the junk. It acts as an anti oxidant preventing its formation. Aspirin is also useful as it thins down blood and prevents clots.

3. Re blockage is common; but it doesn't mean that it will re block as immediately the next time as well. There are instances where the second time around, patients have done very well. You need to continue with good diet and lifestyle you have been following till now to keep yourself healthy and to prevent such events again

Hope my answer is both useful and reassuring. If you have more doubts I will be glad to answer them. Please accept this answer if you do not have any further queries.

I wish you good health.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rakesh Madhyastha (2 hours later)

Thank you. I can't imagine anything I've done wrong to cause a re blockage so fast. OK then. We have all heard about oxidents and taking vitamins to fight and reduce them. Some of the meds I'm on may have interactive negative results with anti oxident vitamin suppliments which means I can't take them; or, can I? My Cardio Doc says vitamins have no effect. He also said no matter what I do, if it's genetic, will have little effect as a vitamin regine approach. He also recomends One glass of red wine/day. Is there a chemical agent in red wine that is safe, will not have a neg effect on the meds, and, will promote a sort of non stick teflon coating to this "Junk" in the blood. I guess, the bottom line here is just that - What can we do or introduce to the bloodsteam to prevent or slow down the sticking together and or plaque build up so darn fast in ones arteries. Also, there seems to be a definate correlation of superspeed deposit build ups in and on the areas where the stent was placed or angio was performed which indicates the body looks at the procedure as an injury and floods it with the "junk" as a sorta pprotection that, unfortunatly backfires you right back into the operating room. I appreciate your help, very much. By the way, my total cholesterol is 106, Triglycerides are 62. LDL is 43 and HDL is 51. Good #'s eh? But, should they be even lower, in my specific case?

Answered by Dr. Rakesh Madhyastha (16 hours later)

Thanks for replying

I understand your concern.

Atherosclerosis/plaque (junk) formation is a chronic condition. The current medical treatment is based on reducing the risks factors that increases the chances of its formation. Accordingly, the following things are useful.

1. Statins- they reduce lipid particle deposition by lowering cholesterol.
2. Aspirin- They reduces platelets from clotting up and depositing by thinning blood.
3. Vitamins- They reduces endothelial cells from depositing based on its antioxidant role.
4. Exercises- Keeps your heart health and reduces over all cholesterol

The medications given to you is appropriate. They do not have any interactions with each other. Do continue them as instructed by your doctor.

Red wine was suggested by your doctor in moderate quantities to increase your HDL which is also known as good cholesterol. If you are uncomfortable with wine you can take omega fatty acids. Drinking red wine also won’t cause any interaction with your drugs.

You cholesterol is looking excellent. Please continue the treatment given to you

It is true that existing stents are more prone for plugging than the rest of your arteries. The risks of stent plugging are lowered by use of medicated stent and reducing the overall risk factors. Just because the first one got plugged fast doesn’t mean it will get plugged equally fast the next time as well. Things to do to avoid plugging of the stent are as follows:

1. Avoid smoking
2. Avoid red meat
3. Avoid fatty food like cheese, butter, ghee, fried foods
4. Avoid excessive alcohol consumption. (More than 40 grams/ day)

Your doctor was right with genetics playing a role.

I hope I have answered your query in detail. Please accept my answer if you have no further queries.

I wish you good health

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rakesh Madhyastha (10 hours later)

Thanks. I've done some study and it appears the Omega 3"s are not good to take in conjunction with my meds as it may promote even more blood thinning and apt to bleeding along with too low blood pressure. To raise my good cholesterol, I am on Niacin which has done a good job. All these things you say to do, I have done for the last seven months. I'll keep it up. Do you think a multivitamin would be ok to take with the meds I'm on? Further research indicates adding Folic acid, Vit's B6 & B12 could help fight, in an antioxident way, the Homocysteine levels in my blood, reducing them, and vit pills contain these. As I understand it, studies indicate much higher rates of heart dis., even among the young, who show high levels of this where those with low levels have next to none. Also, candidates put on the lowering of this Homocysteine after angio surgery were free of Restinosis after one year. In your pro opinion, should we attack this with antioxident vitamin suppliments in conjunction with my meds, eating right, exercise, etc? Thanks again.

Answered by Dr. Rakesh Madhyastha (5 hours later)

Hello

Thanks for the query

Studies also indicate that Vit C deficiency has shown to increase atherogenesis. As I have indicated in my previous reply there is no harm in taking multi Vitamin pills along with your medications.
I must add that not all studies are genuine and some drug interaction though present will weigh out on the benefits.

Homocysteinemia is a genetic disorder and not only are these people more prone of heart disease but also stroke. This does not apply to you because I dont think you have that problem.

I hope I have answered your query, please accept my query if you have no further
questions please accept my answer

I wish you good health

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rakesh Madhyastha (35 minutes later)

Should I ask my doc to test my blood for the Homocysteine levels and why would you think I don't have those higher levels? Thanks.

Answered by Dr. Rakesh Madhyastha (23 hours later)

Hello

In hyperhomocystenemia there is medial dislocation of the lens and also it is not a very common disease.
Your doctor has already put you on Folic acid which is the treatment for it anyways. To be on the safer side you can get it checked. Please mention this to your doctor on your next visit

I hope I have answered your query, please accept my answer if you have no further queries

I wish you good health

Regards

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Raju A.T