pacemaker and stents-can they go together?

Hi me again! Does anyone know if the veins the pacemaker lead is in can be stented to improve blood flow? Or would this cause damage-either further to the vein or to the wire? Really need some advice on this. Doctor doesn't listen to questions and don't have the money to seek second opinion.
Thank you x

8 Comments

Stents & PM Leads

by donr - 2013-11-27 03:11:11

I think there is a comment on this currently on the open thread page. IIRC, Golden_Snitch wrote it. The answer I recall was a resounding "NO!".

IF this is correct, run like a bear is chasing you away from the surgeon that wants to put one in under those conditions.

Don

No

by golden_snitch - 2013-11-27 03:11:18

Hi!

My whole cardio team, including head of EP department and head of cardiac surgery department, say that they won't stent a vein with a pacemaker lead inside, nor would they take the lead out, stent the vein and put the lead back in. Stenting a vein with a lead inside means that you push the lead against the wall which can cause rupture of the vein and/or damage to the lead.

We were discussing this a few years ago when I had severe stenosis of my left subclavian and innominate vein. I have one pacemaker lead inside those veins. Instead we chose to put me on something like Warfarin. It has definitely helped to improve the blood flow. Also, the good thing about veins is that they quite easily grow collateral veins around passages of stenosis or blockage. My team said that they would not have put me on Warfarin, if I hadn't had symptoms and a reconstructed vena cava superior that was at risk of re-stenosis. Doctors said that over the months and years collateral veins will for sure provide a bypass, so nothing needs to be done in asymptomatic patients.

If I were you, I'd talk to your doc about starting a blood thinning medication. Doesn't need to be Warfarin, can be one of the novel oral anticoagulant agents, like Pradaxa or Xarelto. Those are approved for deep vein thrombosis, too.

Best

Inga

thank you

by FighterGirlxx - 2013-11-27 03:11:40

Hi

That is great to have such great feedback! I have had a massive clot in jugular and subclavian and some left over but told that it is normal for some to be left behind. I have post thrombotic syndrome and it is not improving despite doing everything I have been told to.

I was on warfarin but scared off it by the doctor-now I don't know if it is slowly worsening because of the damage or because there is something new going on. Hematology doctor said that they stent blocked or damaged veins all the time but I have no idea if this includes people in my situation.

I still have pain, swelling, altered colour and tingling at times. I never realised that a stent placement could potentially damage the vein like that or damage the wire (I am guessing to the point of potentially requiring replacement?).

I wish so badly this yhings were straightforward!!!!

Thank you for your help x

can't find it

by FighterGirlxx - 2013-11-27 03:11:46

Hi Don
Thank you for replying! I am not having any luck finding the previous post -it is probably a silly question but where is the open thread page?

Thank you again!

warfarin

by FighterGirlxx - 2013-11-27 05:11:40

I was told that there is no need to be on it if I don't want to be (till then I had no issue and actually felt much more alive on it than before or since) and that stats were not statistically insignificant in relation to the number of deaths from coumadin itself which scared me. Given no clinical advice beyond stats I felt that with being scared and being told stuff about 6 month duration etc etc etc that I had to come off as despitebbegging for advice I have had what feels like regurgitated blurb from a book.

Pls Explain

by donr - 2013-11-27 05:11:59

Your being scared off Warfarin by the dr.

Don

Reconsider Warfarin

by donr - 2013-11-27 06:11:29

There is NO drug that is totally w/o side effects/dangers. Would you believe that a PLACEBO can have deaths associated w/ taking it ?

If you have a clot somewhere, Coumadin is prescribed to prevent further clotting & the potential for a piece of the existing clot to break off & migrate to the brain or lungs & causing a worse problem - like a pulmonary embolism or a cranial embolism. Both of these can cause death or permanent debilitating after effects - like paralysis, inability to talk & all the other wonderful effects of a stroke.

Someone has to balance the positive effects against the negative & determine the relative risks involved & decide which is worse for the patient.

If the fear of something going wrong from Coumadin & stats (I assume that you mean statistics) are affecting your quality of life, I suggest that you either NOT ride in an automobile or get into a bathtub/shower. More people die in auto wrecks & from falling in a tub than from Coumadin!

You have one other choice - delve into the statistics & realize that most of the deaths are in OLD people, as opposed to young sprouts, like yourself.

OOPS!!!! I forgot another point - at least you can control the INR factor w/ frequent blood tests - an annoyance, yes, but makes Coumadin much safer to take. You like spinach? Your INR gets too high, eat a batch of spinach - about 1/2 lb in a setting & it drops the INR like a Uranium brick.

From the way your Doc talks, you face a threat from that clot for a long time yet.

Do some REAL research & stop listening to gloom & doom sayers. For any drug, there are the the naysayers, even for those that have been around for years & have an established track record of safety. If you don't understand what you find , write & ask us. one of us will know the answers.

Don (Coumadin for 11+ yrs)

Nobody does this

by PacerRep - 2013-11-27 11:11:23

I don't know of anybody that will stent a vein with a lead in it for several reasons. The biggest one is that it will do absolutely no good to do so. The scar tissue will just rebuild up around the wire and into the stent causing even more occlusion.

The other reason is that the wire's go in veins that don't really need to be stinted even if it's occluded. Your body will just build collateral vessels to get the blood where it needs to go. If someone is trying to stent your sub-clavian, ask to see their medical license and get out of their van.

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