Heart stents

[leblarj]

Has anyone experienced having coronary stents put in place while having APS?

[HollyHeski Administrator]

Hi, not with coronary but subclavian arteries, for me, even though they tried to put stents in, (both subclavian & celiac arteries stenoised), they were unable due to the stenosis being too close to other arteries.

They still used angioplasty and the risks to me were the same with/without stents.

The bridging plan is the same risk with and without too.

Cardio and vascular surgeons now are extremely skilled and will only do these procedures knowing the full extent of APS, showing full caution to minimise the risks.

Hopefully others will come forward and share their experiences more to answer your question.

[MaryF Administrator]

Hi, do you have a diagnosis for Hughes Syndrome/APS? We always ask people this when they join this forum. I am sure other will answer you, if they have had this procedure. MaryF

[leblarj in reply to MaryF]

Triple positive with a large left Subclavian Artery non obstructive filling defect discovered on dye CT Scan after three fingers went into cyanosis . Jan 2018. Confirmed APS in Aug 2018. They were off the beaten track at first cause subclavian artery issues are usually due to Atrial Fibrillation. In my case it ended up being APS, although who knows, I could have also have been in A-Fib at the time I developed the subclavian clotting and reverted back to sinus rhythm before I got to the hospital.

So I just had a stress test in Dec 2019 that indicated I should have an angiogram for a look see, and I was having a hard time getting some straight answers from the interventional cardiologists about APS and stents. I forwarded them two medical articles where two patients elsewhere had stents inserted which clotted within mere minutes of being inserted, and these patients were later discovered to have APS, unknown at the time of their procedures.

I asked if they had an APS protocol, they said no, but they dealt with patients who had factor V Leiden and others who were prone to DVTs and PEs, so they looked at it no differently was what I was informed.

I never got anything clarified prior to the procedure, but rolled the dice and went ahead with the procedure anyways. They found a 90-95% blockage of the Right Coronary Artery close to the origin, so all the branches were affected downstream.

I developed a hematoma at the radial wrist artery insertion point. I still have no knowledge as to whether they addressed the issue with stent clotting dangers as I presented to them in the medical articles, or if it was a wait and see thing, but my understanding with them prior to the procedure was that I would remain at the cardiac centre overnight as a precaution was not honored and I was put in an ambulance for a two hour trip back to the hospital. It was during the ride back that the hematoma developed. The ride back in itself should not have occurred simply due to weather, it was freezing rain and slushy, the ambulance driver was saying she was having a hard time keeping it straight, and even stopped at one point to see if a tractor trailer and car that went off the road ahead of us were in need of medical assistance. But I digress.

[MaryF Administrator in reply to leblarj]

Thank you for replying with so much detail. MaryF

[jetjetjet]

Hi I have had 4 surgeries -{ non heart } but different parts of body and the Bridging for all of the operations and all of my spinal injections the Bridging protocol has always been the same so i would think that would be the same .

[GinaD]

I do hope you can choose a well defined path forward. I have a congenital a fib which currently is well controlled by a Ca channel blocker. But surgery may be in my future, so I am eager to share in any knowledge you glean.

[Kerlampert]

No, but I had a mechanical aortic valve replacement. The bridging procedure was developed between my rheumatologist and my surgical team. It went well.

[yodak]

Yes, I have had two stents placed in the last four years. I came off coumadin and started with lovenaux before the stents were placed. I have had no problems with these

procedures. I think APS was a factor in me having the blockages in the first place. Who knows! I am 73 now and have had APS treatment with blood thinners since my early 20's.