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Follow up and still left wondering to stent or not to stent?


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Hello all,

 

I had my follow-up with my Neurosurgeon yesterday and left a bit uneasy. A shortened background: I had an aneurysm Dec. 10, 2010 and it was coiled. The same aneurysm ruptured again July 17, 2020 and was coiled again. The previous coils were still intact but a new aneurysm branched out off the old one. This is very rare to happen.

 

Prior to my coiling there were talks of putting a stent as well. This was not done. My husband and I were told by two of the Neurosurgeons that it is needed as an added protection to not have another rupture.  I was discharged after the mandatory 14 days and never heard about the stent again. 

 

This has caused me lots of anxiety. I told my husband that we have to be ready to fight (not physical lol) and advocate for myself and so we did. 

 

Doc said there is some remnant which is not uncommon. He showed us the CT scan and where my aneurysm is located is quite tricky. His words were, "There are no right or wrong answer. It's not black and white. It's gray." He also said that for every procedure there are always risks and that if we do the stent I will be on blood thinners forever. 

 

He probably saw the look of dismay on our faces. I was on the verge of tears. My husband said well we have to do something, anything. Everybody said a rerupture was unlikely but it did happen. Thankfully, Doc said we'll let the coils settle in and do an MRI in three months and go from there. Got to take the small wins.

 

My question is: For you who had stents put in, how was the procedure? Are you on blood thinners? How has it affected your life? 

 

Thanks in advance!

 

 

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Hi Ann, 

 

I'm sorry to hear you are in this situation.  I can't answer your questions unfortunately, because I've not had a stent inserted.  I can empathize however, because twice in the past 12 years since my bleed, I have been in the situation of my neuro team talking to me about having such a procedure and likewise mine is in a very challenging spot.

 

I was also told I'd be on blood thinners for life if I were to have the procedure.  Last year I got to the stage of an angiogram before they decided my aneurysm was stable enough not to put a stent in, but I still have annual scans so I doubt I'm out of the woods just yet, which just means I have this concern constantly at the back of my mind.

 

Hopefully you will know more when you've had the MRI in 3 months' time.  In the meantime try and relax and enjoy the upcoming festive season or as much as we can in this crazy climate! 

 

Take care,

Sarah x

 

 

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Thanks, Sarah! I have read the thread regarding your situation as well. I agree with you that the concern is always at the back of my mind. I have put my life in a sort of hold anticipating that another surgery was in the books but alas another question mark. I have decided that I would not dwell on it though. And yes, I am looking forward to Christmas. I love the Holiday Season! 

 

Thanks again and stay safe,

Ann

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Hello Ann,

 

I'm sorry to hear you have to go through this. I have had stents put in as one of my two aneurysms was in a tricky place and they were not able to coil it. For six months after I ate two blood thinners, and for six more months just one blood thinner. After that I have not had to eat blood thinners at all. 

 

One stent was put in while I was sedated so I don't remember that, but the second stent was put in during an angiogram before I was discharged from the hospital after I had my bleed. I didn't feel much at all while they were doing the procedure and it was rather quick, but I was half asleep so I think they gave me some meds to keep me calm. 

 

Since then I have done two follow up angiograms, the first one was one year later and then another two years after that. The blood flow through the stents was completely normal even without the blood thinners, and they couldn't see the aneurysms anymore (they were tiny to begin with, though).

 

They have now discharged me completely, so I won't need any more scans. So, in my experience, I don't think having stents have affected my life more than having coils put in have. 

 

I wish you the best, take care!

/Tina

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Thank you so much for sharing your experience, Tina.

 

I wonder why he would say that I will be on blood thinners forever? 

 

I am happy to hear you are discharged completely. Take care and again, I appreciate your response.

 

☺️ Ann

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I was wondering myself why I was told that one year of blood thinners would be enough. The explanation they gave me at the time was that after about a year the mesh of the stent would have merged completely with the tissue of the blood vessel and that the risk of a blood clot would be smaller after that.

 

Maybe there are different kinds of stents? Also, I'm in Sweden, so perhaps the recommended treatment is different here. 

 

/Tina

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Hi again Tina,

 

Yes, I believe there are different kinds of stents. My Neuro told me the stent they would be using if they eventually do so is from Europe and would need an approval from Health Canada because it is not yet widely used here. How special! ☺️
 

That is very interesting...thanks again! I’m writing down questions for them for my next follow up. 
 

We’ll keep in touch!

😊 Ann

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Yes there are different stents and same with heart stents too. Some stay on blood thinners for one year. Long ago, they had to do hernia surgery on one of my patients but he had stents and he can’t stop the thinners. So they did it while on blood thinners.  Patient did well. They also carry a little card in the wallet telling what kind of stents that is. 

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