I had stent put in for a right ICA aneurysm and had minor strokes shortly thereafter. This was due to the stent thrombosing despite having been on Plavix before and after the procedure. Parts of that clot broke away, travelled and got lodged somewhere causing the stroke. My right artery in the neck leading to and around the stent is blocked and I was told will probably stay that way. It will, however, not cause anymore strokes as the clot has “stabilised”. After an MRI and extensive blood tests to rule out possible blood clotting disorders (all normal but one result still pending), doctors tell me it might be a case of Plavix simply failing me. I am not one who takes any medications lightly. The strongest med I took before all these is just over the counter paracetamol and even very rarely so. If in future I need to have a procedure requiring anti-platelet drugs, will I risk another stroke because Plavix will not do what it is supposed to do? I only have one working artery now. Doctors say there is no alternative to Plavix. Although there a drug called prasugrel which is similar to clopidogrel (Plavix). I believe that candidates for stenting should be checked for this before their procedure. Thanks for listening to me.
I just joined today and am new to this subject, but I just read an article today on msnbc on stents and strokes. It might not pertain to what happened to you, but here it is:
http://www.msnbc.msn.com/id/44432757/ns/health-heart_health/
Thanks for taking the time to research this for me. I think it pertains to inserting a stent to unblock the arteries caused by plaques, etc. to prevent strokes or further strokes. My strokes occurred after the stent insertion which blocked/thrombosed. The link is great though as it tells me that it is best to leave the blockage alone - the aspirin will do the trick. Welcome to this great forum and good luck to you.
Chris,
Am sorry to hear of the troubles you have experienced due to the plavix. I too have ICA annies, both at the ophlthalmic artery, one having been stented back in June, 2011 with the pipeline stent. Did you also have the pipeline? I have been on plavix since 10 days before my surgery, with little or no side effects from the drug itself. I am really sorry this isn't working for you and I hope that people will read your post and question their doctors on whether they can take plavix or not. I can tell you that when I had my surgery, they tested my blood 1 hour prior to surgery to make sure that the aspirin/plavix regimen that I was on was at the right level so they could go on with the surgery. Did they do that to you when you had your surgery? Am just curious.
Best wishes to you in your healing. My thoughts and prayers are with you.
Linda
I think that in reading my post op report, there were several times during the (3 1/2 hr) surgery where they noted my blood levels re the plavix/aspirin (were you also on aspirin too? I was) - maybe it was just that they checked it pre and post - but I do believe, like Linda, that they were checking it. Maybe get a copy of your op report if you think it may have been doctor error…
All I know is that the Plavix and aspirin worked so well on me...I bled during surgery in my esophagus and my groin...they took me off the Plavix and I had transfusion and I will continue to be on 325 mg of aspirin the rest of my life...
I hope you find some better answers...
cyber~thoughts Colleen
Linda,
Thanks for your concern. I did have a pipeline stent and one of the best ones I was told which is why the doctors are baffled. I am trying to remember how long I was taking the Plavix and aspirin before my procedure and I think I only had 2 doses of each before the surgery - the night before and the morning of the procedure. Maybe it was not enough as you had 10 days! I had been blood tested before and after for as many times as I can remember but what the blood tests were for I am not sure. The doctors firmly believe Plavix should have helped with the anti-clotting and in my opinion, I don't think that they had it in their mind before my procedure that it will not work for me so I do not think the blood test was to see if Plavix/aspirin is working as a normal part of the procedure. I might be wrong though as you and Jaycie have been monitored for this before and during. You have gotten me very curious. Was my dose enough? Did they check my blood levels for this? I will bring this up with my IR doctor and neurosurgeon next appointment. Thank you. I did not even think about this.
Jaycie,
Thanks for your reply. My response to Linda goes to you as well. You both have gotten me really curious about this. I might get a copy of my op report. How many doses of Plavix/aspirin did you have before the procedure?
Thanks for your response Colleen. I’m glad it worked for you. May I ask how much dose you had before your procedure? I will be on aspirin forever too. Plavix was stopped after 3 months (no point is there?),
Chris,
I actually went first to have a coiling done,but once they got inside they realized the mouth was too wide. They actually woke me up and sent me home, because they said i needed to be on plavix and 81 mg of aspirin for 10 days prior to being able to put the pipeline in. Exactly one hour before they took me into surgery, they drew blood to make sure the plavix/aspirin in my system was at the right level. They actually told me that if the plavix/aspirin was not at the right level, they would pump me with both until my levels were right before they would do the surgery. I definitely would ask the surgeon what the difference in that is. I will be on the plavix for 6 months, until at least my angio follow up in December, and the aspirin the rest of my life.
I can also tell you that my doctor, and the doctors at Jefferson Hospital for Neuroscience in Philly are proctors for the pipeline, teaching doctors around the country how to do the surgery for it. Please do check into that, I think it's worth the investigation.
Hugs your way,
Linda
My husband just had his six month check up. They had him on Plavix shortly before the procedure but when they did the blood work before his angio they said that he was non responsive to it at all, there was none showing up in his blood work. Since they did not expect they would have to do anything they went ahead with the angio. The nurse later told us if they ever needed to put in a stent that there was another drung they could give but that it had real bad side effects and would only use it if absolutely necessary.
Thanks for bringing another side to this and I pray your husband will do better than me. May I ask? If there was none showing up in his blood work, what made the doctors think he was non-responsive to Plavix at all? How much dose did he take before the angio? I assume the angio was just a preliminary check-up since you mentioned that they could use another drug IF they needed to put in a stent? Sorry for all the questions. I started this thread not thinking it would be much of an issue. After reading all responses (for which I am grateful), this has made me more and more curious.
Good luck again to you and your husband.
Hi Cris, I had a Stent Pipeline in January, 2010 in Italy.
I took plavix and aspirin 10 days before the surgery and up to 4 months later.
This is the normal routine applied in Italy.
Take care of you.
Giovanni
I don’t remember exact amnts - I know I took a huge dose of plavix the night before, and then more the morning of. I also remember that they upped my aspirin from baby aspirin (81?) to adult aspirin (325) because it wasn’t showing high enough levels in my blood - can’t remember where in the timeline that took place, I think soon after the surgery. I was then on lower dose of plavix, plus aspirin, for about 10 weeks (I think 8 was standard, but I was going to Mexico so we decided to keep me on it until I returned), and then only on the aspirin until my 6mos follow=up, at which point I was taken off the aspirin as well.
Thanks Giovanni, everyone seems different, I guess based on the bloodwork and the aneurysm. Can’t wait for my next appointment so I can bring this up with them. Take care too.
My dose is similar to yours Jaycie except I will be on aspirin for the rest of my life I was told. I think this is more due to the fact I had a stroke and clotting around my stent. Thanks for answering my question.
He had only taken the Plavix for a week since it was just for his six month follow-up angio. I am not sure the actual dosage of the pill. They believed him to be non responsive to Plavix since the blood work came back with no indication that he had taken the Plavix at all. They acted like this was nothing out of the ordinary and that just certain people do not respond to it. They had to add more coils but all is well. Hope you find answers as to what happened. Take care.
Cris, I am so sorry for all you are going thru.
Just in my newspaper is an article "Stent to prevent strokes fails in study...A promising device to prop open blocked arteries in the brain in the hope of preventing disabling or fatal strokes in a rigorous study, researchers reported on Wednesday. The website is:
http://seattletimes.nwsource.com/html/2016138768_stroke08.html
I have not read this yet; do not know which stent(s); sometimes my typing and or send does not transmit the website correctly.
I am aware of Wingspan, which I understand is to use after angioplasty (the plaque stripper) ...tho the patient labeling also noted that re-stenosis can/may occur in the stents. I thought it odd that is in the patient labeling of Wingspan and not in Neuroform2 or 3 patient labeling; perhaps these patient labelings have been revised; I do not know.
Cris, I know that I am missing at least one major artery w/in my brain (intracerebral, not intracranial) We all know TBI is traumatic brain injury...I stuttered so much...came up with TTBI...traumatic treatment brain injury. There is no record of a planned by-pass; in the diagnostic angio story, that artery is noted as not having any aneurysms; not that it was no present.
Has your neuro explained which segment of your Rt ICA is the location of your aneurysm?
Same for location of the stent(s)? If not, please ask him/her to explain it over the images. Stents have what are called marker bands at either end of the stent. Between those and metallic artifacts, I just glow.
Likely blood tests were done before you were placed on Plavix that should reflect your natural platelet level and the rest of your blood levels for the comparison of the mds.
I had a bad reaction on Plavix as well; two mds said it was just a bruise; yet it was a white lump with a red streak; the darkened bruise appearance encircled the white hive ppearing spot. My family took pictures of it.
Prayers for your best treatment / recovery. Please ask your mds more questions as needed.
Pat
Thanks for your thoughts Pat and for sharing the article. It pertains mainly to a study on whether putting a stent to widen or open up a blocked artery (due to calcification, cholesterol build up, etc). That subjects who used medical intervention (drugs and/or lifestyle change) performed a lot better than those who had stents.
My aneurysm is on the right distal paraopthalmic internal carotid artery. I developed an intravascular internal carotic artery clot beneath my stent all the way to my neck artery as seen from my MRI Neck. The left artery compensates for the right side as is the nature of the brain (Circle of Willis) but I am still not happy about it. If, God forbid, doctors need access to my right side, what happens then? I am not worrying about this though as I don't want my present to be affected by a probable future event. I have to write all my questions down for next appointment as all the posts in my thread has really made me think. It seems though that Plavix does fail for some people and blood tests might not be enough to allow doctors sufficient information to decide on how much one has to take for Plavix to work. I had a test called "clotting time" when doctors ordered extensive blood tests AFTER my stroke. This might not be part of the regular blood tests done to patients about to receive a stent but maybe it should?
Pat, thanks again for your response. I try not to think about the blockage because really I feel almost back to normal. Even if the brain is not what it used to be but then everything else is working okay. I hope you are now off Plavix if it is giving you grief. I'm sure you do not need another issue to deal with. May you get stronger and healthier each and every day.
Cris, I had only an 8 week supply, and came off it early...it was for time following an angio/stenting. Maybe we need more research on all stents?
Was yours implanted before, during or after the coiling?
Thank you for blessings...
Prayers to you for your continued recovery.