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Cardiac and Vascular Consultants
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Cardiac & Vascular Consultants (CVC) is the premier cardiac and vascular practice serving community
A Thank you letter for Dr. Upadya
A Thank you letter for Dr. Upadya
Ground-Breaking Heart Monitoring Technique
Congratulations to Dr. Hassan Baydoun and Dr. Alaa Boulad for a successful CardioMEMS implantation performed at Citrus Memorial Hospital
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Two great cases last week with Dr. Aloul.
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Even with great care, patients can still have issues with their stents.
Anytime you receive a stent, you will be placed on dual antiplatelet therapy for 3-6-9 months, sometimes for life. Plavix, Brilinta, and Effient are the three antiplatelet medications, in combination ASA.
About 1 in 4 people who undergo angioplasty with stenting develop in-stent restenosis. This tends to happen three to six months after the procedure. Restenosis is even more likely to occur when you don’t get a stent. About 4 in 10 people who undergo balloon angioplasty without stenting experience restenosis.
After angioplasty and stenting, tissue grows over the stent to form a new lining for the artery wall. This lining allows blood to flow smoothly, lowering the chances of a blood clot forming within the stent. It’s not uncommon for some scar tissue to form underneath this lining. But when there’s too much scar tissue, the lining of the artery can get too thick and slow blood flow again. In-stent restenosis typically occurs within three to six months after treatment. It’s unlikely to occur later than that.
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In-stent restenosis and patients with diabetes.
Restenosis is caused by an overgrowth of scar tissue. When a stent is first placed, healthy tissue from the lining of your cell walls grows inside of it. This is good because it keeps your blood from clotting as it flows through the stent. However, scar tissue may form underneath the healthy tissue.
Diabetic patients characteristically have increased endothelial dysfunction associated with increased platelet activity and a more aggressive cellular response to injury. Most studies have shown female gender to be a predictor of restenosis.
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Renal artery stenosis is narrowing of the one or both of renal arteries. It is the major cause of hypertension and according to some reports is the cause of hypertension in 1% to 10% of the 50 million people in the United States.[1] Atherosclerosis or fibromuscular dysplasia most often cause it. Other associated complications of renal artery stenosis are chronic kidney disease and end-stage renal disease.
There are two major causes of unilateral renal artery stenosis (RAS):
Atherosclerosis (60% to 90%): Atherosclerosis primarily affects patients (men over the age of 45 years) and usually involves the aortic orifice or the proximal 2 cm of the main renal artery. This disorder is particularly common in patients who have atherosclerosis, however, can also occur as a relatively isolated renal lesion. Any of the multiple renal arteries (occurring in 14% to 28%) may be affected. Risk factors for atherosclerosis include dyslipidemia, cigarette smoking, viral infection, immune injury, and increased homocysteine levels.
Fibromuscular dysplasia (10% to 30%): In contrast to atherosclerosis, fibromuscular dysplasia most often affects women younger than the age of 50 years and typically involves the middle and distal main renal artery or the intrarenal branches.
Below is a recent procedure done by Dr. Upadya at our outpatient procedure center Lake Cardiovascular Diagnostic Center.
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Our physicians are dedicated to help improve patients life styles, healing wounds, and be active in their community!
Below are a few examples of patients that had symptoms of claudication (pain with walking). Both patients had 100 % blockage of blood flow to lower leg.
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