Is it unusual--or dangerous--for a person who had a cardiac
stent inserted in September (4 1/2 months ago) to be able to
feel the stent when he moves certain ways (prone, for example)
or breathes deeply?

Hello Betsyj,

   
I urge you to discuss this with your cardiologist. Its possible that
what you are feeling is  not the stent itself, but the sensation of a
decreased amount of oxygen, or scar tissue. Scar tissue may have
obstructed the stent, necessitating a re-stenting. When a stent
becomes obstructed, it is called restenosis, and typically occurs 3-6
months after the original procedure in about a fourth or more of stent
patients.

   This answer is in no way intended as a diagnosis or to replace the
advice of a licensed physician, and is for informational purposes
only.

?When a stent is placed in a blood vessel, new tissue grows inside the
stent, covering the struts of the stent. Initially, this new tissue
consists of healthy cells from the lining of the arterial wall
(endothelium). This is a favorable effect because development of
normal lining over the stent allows blood to flow smoothly over the
stented area without clotting. Later, scar tissue may form underneath
the new healthy lining. In about 25% of patients, the growth of scar
tissue underneath the lining of the artery may be so thick that it can
obstruct the blood flow and produce an important blockage. In-stent
restenosis is typically seen 3 to 6 months after the procedure; after
12 months have passed uneventfully, it is rare.?

?After the procedure, patients should lead a heart-healthy lifestyle
that includes a diet low in animal fat, regular exercise, blood
pressure control, cessation of smoking, and minimal alcohol
consumption. Regularly following-up with a cardiologist and taking
medications as prescribed are also important preventive measures.?
http://circ.ahajournals.org/cgi/content/full/105/22/2586


?But stents are not foolproof. Some patients may have a repeat
blockage. New stent developments, and the use of powerful drugs along
with the stents, should make the success rate even greater.?
http://www.health-alliance.com/living/Heart/heart_11-99.html

?The majority of patients who go home after a successful procedure
have no further problems. In some patients, however, the narrowing in
the artery may return. Such recurrences, called "restenosis," most
often occur within the first three to six months after a procedure. If
you have pain after you are home, it is very important that you tell
your doctor. This may be the first sign that you are developing a
restenosis.?
http://www.guidant.com/webapp/emarketing/compass/comp.jsp?lev1=living&lev2=stent

?Eliminating restenosis is not completely within the patient's
control. Under ideal circumstances including a low-fat diet, use of
medications and exercise, additional plaque and blockages should not
form. However, restenosis can occur for a variety of reasons, some of
which have to do with the artery's ability to heal or the strength of
the arterial walls.
The best advice is to follow your doctor's instructions and be
vigilant about following up with stress tests. This will ensure that
future blockages are detected and treated quickly. If you experience
any chest pain or discomfort, contact your doctor and seek medical
help immediately.
http://www.heartinfo.org/ms/guides/17/main.html



?Call your doctor's office if:
?	The catheter insertion site starts bleeding or swelling
?	You develop increasing pain or discomfort at the insertion site
?	You have signs of infection, such as redness, drainage or fever
?	There's a change in temperature or color of the leg or arm that was
used for the procedure
?	You feel faint or weak
?	You develop chest pain or shortness of breath
You should be able to return to work or your normal routine the week
after angioplasty.
http://www.mayoclinic.com/health/angioplasty/HQ00485


?	?Chest pain
?	Your arm or leg becomes painful, blue, cold, numb, tingly, swollen,
or increasingly bruised
?	Cough, shortness of breath, chest pain, or severe nausea or vomiting
?	Redness, swelling, increasing pain, excessive bleeding, or discharge
from the insertion site in your groin
?	Extreme sweating or nausea
?	Signs of infection, including fever and chills
http://healthgate.partners.org/browsing/browseContent.asp?fileName=14867.xml&title=Coronary%20Stenting


?In several studies, clinical restenosis has been found to occur in
approximately 36-40% of patients. Thus, a minority of patients with
angiographic restenosis have no clinical manifestations. Most patients
who develop symptoms of restenosis develop these symptoms within the
first 3 months after angioplasty. The presenting symptom in the
majority of these patients is progressive exertional angina. Patients
occasionally will present with unstable angina and only rarely with
acute myocardial infarction. In patients who present with recurrent
chest pain, several features have been found to be helpful in
predicting whether they will have angiographic restenosis at follow-up
angiography. Patients who present 1-6 months after angioplasty with
typical anginal symptoms have a high likelihood of having angiographic
restenosis.?

?A negative exercise thallium test appears to have a high specificity
in ruling out restenosis and may be helpful in patients who present
with more atypical symptoms. Repeat angioplasty is the therapy most
frequently utilized to treat restenosis, although coronary artery
bypass surgery or medical therapy may be reasonable alternative
therapies. Clinical success rates with repeat angioplasty are > 90%,
and major complications are rare; however, restenosis will recur in a
significant percentage of these patients. Some patients who develop
such recurrent restenoses will ultimately benefit from a strategy of
repeat angioplasties, although many will require surgical
revascularization.?
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8608668&dopt=Abstract

I hope this helps you out. Only your cardiologist can accurately
diagnose your symptoms, as s/he is familiar with your medical history.
Please visit your cardiologist soon. If you should need another stent,
discuss the possibility of using a newer drug-eluting stent with
her/him.


Please request an Answer Clarification and allow me to respond, before
rating this answer, if any part is unclear. Good luck!

Sincerely, Crabcakes


Search Terms
=============
Living with + cardiac stent
Restenosis

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Request for Answer Clarification by betsyj-ga on 17 Jan 2006 15:20 PST

Thank you.  I am aware that scar tissue is one possibility.

But my question is, could this person be feeling the stent
itself, and if so, is this unusual or dangerous?

---

Clarification of Answer by crabcakes-ga on 17 Jan 2006 15:37 PST

I agree with markvmd, below in the comments. You DO need to be seen
ASAP. I found no information anywhere indicating a stent can be "felt"
by the recipient. I can only assume at this point you have a clogged
stent, or it has become misplaced.

Only your cardiologist can address this issue. It is not normal to
feel the stent, unless you are misinterpreting a clogged stent
sensation and or scar tissue.

I did not recommend taking aspirin because I do not know you or  your
medical history. You could have an allergy or be on coumadin.

Good luck! Crabcakes

Good answer after clarification requested.  Thanks.

I am not a physician. This comment is not intended as a diagnosis or
to replace the advice of a licensed physician, and is for
informational purposes
only. I do, however, have a stent.

Run-- figuratively, unless you've been exercising-- to your
cardiologist NOW and explain your sensation(s). If you cannot contact
him or her, give very serious consideration to visiting your local
emergency room. Take an adult strength aspirin, too.

You do not mention which artery your stent is in, but locating a stent
in a bend or curve of an artery tends to cause more problems than when
the stent is in a "straight" bit.

I trust your cardiologist put you on Plavix and aspirin (unless
contraindicated) and possibly several other drugs; a beta blocker, ACE
inhibitor, and statin, to name a few.

With the statement "New stent developments, and the use of powerful drugs along
with the stents, should make the success rate even greater," Crabcakes
touches lightly on the incredible strides recently made in stenting.
Failure rates of drug-eluting stents are comfortably well under 25%
and may be as low as 2% in some populations, though as the procedure
becomes more common it will very likely fail more often.