Post Coiling/Stent Follow-Up....what does your doctor advise?

My surgery was 8 weeks ago - and my doctor's follow up plan is a femoral artery angiogram at 6mos post surgery, then to yearly mra's.

Another doctor (different hospital) does the 6 month follow up angio (femoral artery also), but then doesn't do a 12 month MRA, he waits until 18 months post surgery and does another femoral angio. He believes that once the coils and stent are in place, the MRA can have shadows and be hard to really tell whats going on w the coiled aneurysm. He then follows that with another femoral angio in another 12mos (30 mos post surgery).

I don't have any big decision to make yet - both doctors recommend the 6mos angio, and I will certainly get the 12 mos MRA that my surgeon does - but after that wonder if I should switch to doctor "B's" protocol and get the 2 more angios at 18 and 30 mos.

What have your doctors done?

I also have 2 other small aneurysms that need watching - those could be watched just fine w MRA;s according to both docs - it's just the one doctor feeling that it's too imprecise to really see the coiled aneurysm in a scan.

Thanks

Jennifer

I had coiling (Feb 2010 & March 2010) to the same aneursym with no stents. Since then I have only had MRI's - not through the femoral artery as you mention, just a regular MRI. I asked about the clarity of this with my specialist and he said that they can see the coiling and growth better then with CT or dye MRA's. I have had two follow up MRI's, one April andother Nov with no changes, my next MRI is scheduled for another six months in May. Then if still no change it will be moved to a year or two - still only through MRI. (I have a large neck that I am watching to make sure no more growth - if any changes then I will need to insert the stent and add more coils to close. I have been postponing the stent because I am not ready to do another surgery and I don't want to be on meds all my life if I can avoid it.) My hospital is a university teaching and trauma hospital so I believe that the treatment I receive is state of the art and I trust the care I am receiving.

I think 3 angios is a bit much. Angiograms are themselves fairly invasive and consequently carry risks that MRA’s or CT’s do not. During my diagnostic phase one doctor wnted to do an angio after the CTA with contrast and the doctor I ended up with said an angoi was not necessary because he could see everything fine with the CTA.

Jennifer...Merry Christmas to you and your family...

All of your questions are extensive....and, please give us all time to get back to you...do not feel you are getting limited response...You are blessed to have more than one doc being open and direct with his/her expertise ...I only regret you have so much research to find your comfort with which one....You are blessed that each has expressed it...

More later as i wish you a miraculousy Merry Christmas and a grand Happy New Year...

Pat

Thanks for the responses. I'm curious to hear more - if others want to share their post-coiling follow up plans.

Jennifer

I had an aneurysm clipped 2 months ago, my doctor recommends the Angiogram at 1 year. I don’t think they have to follow up on the clipping like they do the coil. Sorry i don;t know more. Carol

Jennifer,

Do you have the Patient Info Guide on the stent? Typically it is in the stent package and given to a patient to review to make an informed decision when arriving for the procedure....The Guide has a Patient Card-to-Carry for the neuro to list the stent(s) stock label#, for a patient to provide for any future MRI/A. To me, one neurologist elected to follow that; a neurointerventionalist said it was incidental...

If you do not have a Guide, you may access the FDA site that has most of the data. Can put any of the numbers, H020002, H050001, and H060001 in the 'net search line to go direct to the FDA site. On H020002 the FDA site did not have the Patient Guide...tho the available guide is for physicians, it does provide data; the other two are easier to read for similarities, not the same.

You have lots of time before your follow-up to review to determine, which, if any questions, you may have for your neuros in making your decision.

Pat

Linda,

I am curious about the stent needing meds for the rest of your life. Could you explain? I had a 6mm annie coiled and stented because of a wide neck. I was on plavix and aspirin for 7 days before the procedure, the plavix for 3 months after and the aspirin for 6 months after. I just stopped the aspirin Jan. 1, 2011.

Kim

Post coiling I had an MRA at 3 months and my next will be 6 months after that.

Hi Kimberly -

So you had an MRA at 3mos and then another MRA will be done at 6mos? No femoral angios?

And re your other post - I just came off the plavix after 9 weeks and have had more headaches - nagging ones that just won't go away for days at a time - and have wondered if going off the plavix has been a partial cause. I'm still on the 325 aspirin - so I can't speak to that, yet - but hopefully I'll be off that at 6mos, though I'm not sure since I do have a stent as well as coils. I'd bet it's not a coincidence that the headaches have come as youve gone off aspirin - just as mine seem to have increased coming off the plavix. I'm guessing it's just an adjustment reaction - and will go away. That's my plan and I'm sticking to it :)

i had my anny rupture in oct of 09 it was 5mm,i had a 6 mo angiogram done then mra 12 mo,an mra is supposed to be more precise and 3-d or 4-d to where they are able to see everything,im doing great and life is good …i have the most wonderful intervention radiologist…Kenneth Layton of Baylor of Dallas…i would get a couple of opinions if i were u and whatever seems to put your mind at rest and make you feel the safest would be what i would go with…just make sure you retain your peace of mind,sending you prayers and wishing you continued recovery,God Bless

Never had a feroral angio.

I had at least 2 aneurysm that was hemorrhage, and was bleed ing else where in the brain they did a craniotomy and clamped, they did Angiogram and put a stent and coil. He said that he would have to do a anglogram every 2 to 4 months becase of the type. had surgert the 7 of Aug, and the 8th,2010 he went back in to check on Oct Oct,15th. and said he would go back in Jan I have’;t heard yet a day. He said mind was the type to break and spead. they said i could never have another MRI because it would move the metal not sure what they were talking about

I was told that with coil and stent I have to have a lower magnetic level MRI/MRA.

That makes me wonder if I should wear a medic alert bracelet about the metal in my head.

I've wondered about that too - It's actually been on my mind to check out what kind of information I should be carrying on me regarding the aneurysms and surgery, as well as what meds I'm on. I think the last MRA I had (a few weeks post surgery, had a scare so they did and MRA) was a normal one - they weren't concerned about my kind of stent, but that said, I think that most people w stents do have cards they were given by their doctors w/ the details of the stents.

Kim -

I believe that people w/ stents in the brain (us) don't have to be on aspirin forever, but I know that people w/ heart stents do - so that may be some of the confusion. I could be wrong - I've only just gone off my plavix, and don't have my 6mos angio for another 3-4mos so I'll know more specifically about the aspirin then. But I don't mind if it's just taking an aspirin every day....lots of people do that as preventative medicine as is!

Jennifer

I had to have an MRI for another problem and they needed to talk to my doctor about my clips.