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Is Stent Placement Advisable When Diagnosed With Peripheral Artery Disease?
Question: My husband is diabetic, recently had a stroke and also has intermittent claudication and peripheral artery disease with ABI( ankle brachial index) of 0.57 in left leg and 0.9 in right leg. The dr recommended stent placement or arterial bypass. He is having angiogram tomorrow. After reading the complications associated with the procedures I feel concerned. We are leaning toward the stent but I still very uncomfortable with either procedures. He is 46 y/o. We really need another input. Please advise.
Thanks in advance
Thanks in advance
Brief Answer:
Low risks with stent placement
Detailed Answer:
Hello and welcome to HCM. I understand your concern. Thank you for your question.
I understand he is undergoing coronary angiogram tomorrow. If there is indication for this procedure, then it is imperative for it to be done, since it is the only procedure to exactly and quantitatively assess eventual blockages within the coronary arteries. The risks from the procedure come from the contrast agent that is used, but is a minor risk which is taken into consideration, measuring that this is a very important procedure.
As about the stents, it is only after the angiogram has been performed, when an invasive cardiologist decides whether stents are needed or not. Of course, even stents have their risks, such as a certain percentage (8-16% with bare metal stents, and 4% with drug eluting stents) for re-stenosis. But, they are implanted only after carefully judging all patient factors, i.e. clinical symptoms and the quantity of the coronary artery blockage (a blockage above 70% is stented). I would also add that every decision making in out everyday-job is made after carefully weighing the benefits versus the risks.
Therefore, I would encourage you and recommend for the procedure to be done and stents being implanted, if there is indication, as this is now a routine procedure worldwide.
Best of luck.
I hope you find this helpful. I am happy to help, if you have any follow-ups.
Kind regards,
Dr. Meriton
Low risks with stent placement
Detailed Answer:
Hello and welcome to HCM. I understand your concern. Thank you for your question.
I understand he is undergoing coronary angiogram tomorrow. If there is indication for this procedure, then it is imperative for it to be done, since it is the only procedure to exactly and quantitatively assess eventual blockages within the coronary arteries. The risks from the procedure come from the contrast agent that is used, but is a minor risk which is taken into consideration, measuring that this is a very important procedure.
As about the stents, it is only after the angiogram has been performed, when an invasive cardiologist decides whether stents are needed or not. Of course, even stents have their risks, such as a certain percentage (8-16% with bare metal stents, and 4% with drug eluting stents) for re-stenosis. But, they are implanted only after carefully judging all patient factors, i.e. clinical symptoms and the quantity of the coronary artery blockage (a blockage above 70% is stented). I would also add that every decision making in out everyday-job is made after carefully weighing the benefits versus the risks.
Therefore, I would encourage you and recommend for the procedure to be done and stents being implanted, if there is indication, as this is now a routine procedure worldwide.
Best of luck.
I hope you find this helpful. I am happy to help, if you have any follow-ups.
Kind regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. REMY KOSHY
Thank you for answering my question.
But it's not a coronary angiogram it's an angiogram of the lower extremities and stent of lower extremities.
Are they also routine procedure especially in terms of complications especially long term.
But it's not a coronary angiogram it's an angiogram of the lower extremities and stent of lower extremities.
Are they also routine procedure especially in terms of complications especially long term.
Brief Answer:
The same principal
Detailed Answer:
Hi again and welcome back.
The same principal is used for the low extremities, also the same risks and benefits are discussed for this compartment of the body. Yes, these procedures are performed routinely worldwide and are safe and effective in experienced hands. Good luck.
I hope this is helpful. If you do not have further question, close the discussion and rate the answer.
Best regards,
Dr. Meriton
The same principal
Detailed Answer:
Hi again and welcome back.
The same principal is used for the low extremities, also the same risks and benefits are discussed for this compartment of the body. Yes, these procedures are performed routinely worldwide and are safe and effective in experienced hands. Good luck.
I hope this is helpful. If you do not have further question, close the discussion and rate the answer.
Best regards,
Dr. Meriton
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
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