Curious to know what some have experienced with the catheterization procedure and how life has gone with a stent. I'm scheduled for a catheterization @ Houston Methodist. Any comments on your experiences would be appreciated.

I had two stents about a year and a half ago. The procedure itself is a little weird, because you are awake during it. It's a painless procedure, except for the tape removal from the IVs and cath. My only recommendation is shave both arms and both sides of the groin in a wide swath. After the procedure, they'll have you lie still on your back for about 6 hours. There's no tv and no visitors, so bring music or audio book.

There's reduced activity for a couple weeks, then you can ease back into normal activities, subject to your doctor. You will be on blood thinners afterwards and, although they don't tell you, possibly forever. It's a must for 1 to 1.5 years. No elective surgeries during that time. Optional thereafter, but the doctors tend to press you to stay on them. I don't like the blood thinners. Every bump becomes a bruise and I've had two hematomas due to routine construction bumps.

As far as heart issues, I didn't have any noticeable problems before, but luckily a nuclear stress test found my problems before a problem happened. I've been able to return to full workouts and activities. I have placed restrictions on myself, like no whitewater rafting. My doc doesn't want me hitting my head due to the blood thinners.

I had an LAD MI 20+ yrs ago at 41. Maybe things have changed recently, but by far the worst part of the cath procedure was the nurse digging into the side of my groin for 20 min after removal to get the insertion spot to clot so you don't bleed out. And then as FourAggies said, followed by 6 hrs of lying still. I have never been more ready to stand up and move.

I have a drug-eluting stent, and my cardiologist and I have agreed that I will be on Plavix for life. No issues with everyday life other than bruising very easily and bleeding like a stuck pig from any sort of nick, cut, or scrape.

I have never restricted myself from an activity standpoint. Ran a marathon in the same calendar year. I have never smoked or been overweight, and ate very cleanly & exercised regularly for years before and continue to do so. If you smoke, have a less than stellar diet, and don't exercise consistently, I would encourage you to make those needed changes.

One other thing the doctors will probably want is a bad cholesterol number below 50. For me, this meant getting on Repatha. I had been on cholesterol meds for about 15 years and overall had been good around 135 total level. However, a more detailed cholesterol panel showed that my small particle cholesterol was extremely high. Repatha knocked it down to a normal level. I think the late start on cholesterol medicine and not addressing the small particle sizes.

I had a catheterization in July of 1974.

And remember it well.

I was lying on my back on a table, completely nude. And one of the number of people in the room was the best looking nurse I saw in my ten days at the Texas Heart Institute in Houston. Some oohs and ahs would have been nice, but noone said anything.

They stuck the probe up through the femoral artery. It tickled whenever it reached a branch and they had to poke it around to get it to go through.

The entire time, I was leaning up on my elbows looking at the monitor over my right shoulder. It was weird watching them move around and feeling it inside.

Then when they got ready for the barium contrast solution, they made me lay flat on my back. When they injected it, it felt quite warm.

Then they covered me up (finally) and wheeled me back to the hospital room.

Of course, they may have changed it since then.

I didn't have a stent, though. I had an atrial septal defect which they sowed up with surgical steel bailing wire (aka suture) that is still there. I hate metal detectors. I do wonder if I could go through an MRI if it was needed.

eric76 said:

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I had a catheterization in July of 1974.

And remember it well.

I was lying on my back on a table, completely nude. And one of the number of people in the room was the best looking nurse I saw in my ten days at the Texas Heart Institute in Houston. Some oohs and ahs would have been nice, but noone said anything.

They stuck the probe up through the femoral artery. It tickled whenever it reached a branch and they had to poke it around to get it to go through.

The entire time, I was leaning up on my elbows looking at the monitor over my right shoulder. It was weird watching them move around and feeling it inside.

Then when they got ready for the barium contrast solution, they made me lay flat on my back. When they injected it, it felt quite warm.

Then they covered me up (finally) and wheeled me back to the hospital room.

Of course, they may have changed it since then.

I didn't have a stent, though. I had an atrial septal defect which they sowed up with surgical steel bailing wire (aka suture) that is still there. I hate metal detectors. I do wonder if I could go through an MRI if it was needed.

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If you set off metal detectors, probably not. It's not necessarily the magnetic force on it, but it can also heat the metals.

Thanks so much for the replies. I appreciate it.

FourAggies - I see that you didn't have any noticeable symptoms prior to the procedure. Did you go into the catheterization knowing that you would require stents ?

Also, did any of you notice a big difference when you were doing increased physical activities following the procedure ? I'm talking about running, lifting weights, yard work, etc. ?

speckledtrout said:

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Also, did any of you notice a big difference when you were doing increased physical activities following the procedure ? I'm talking about running, lifting weights, yard work, etc. ?

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No personal experience, but I have met plenty of people who stated that they never knew why they were always tired, or always out of breath. Never had any chest pain. But after stenting they had much more energy/stamina.

My nuclear stress test showed two 80% blockages, so I knew I was going to get them, unless the test was proven wrong. I was mid-60s and ran about 2 to 3 times a week and lifted weights 2 to 3 times a week, including a lot of daily walking. I didn't feel any symptoms before or really feel better afterward. Just felt the same, except that I probably had more confidence in my health afterwards. The PT afterward seemed very slow to me, but it got to the point that I was doing more outside of PT, then with PT.

This was 20 years ago but the procedure hasn't changed much. I worked for a company that manufactured vessel closure products (to minimize time and risk post-procedure). They let us (not sales/clinical) watch a procedure live, in the room, right next to the patient. It's pretty cool to see such immediate blockage relief with a minimally invasive procedure.

eric76 said:

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I had a catheterization in July of 1974.

And remember it well.

I was lying on my back on a table, completely nude. And one of the number of people in the room was the best looking nurse I saw in my ten days at the Texas Heart Institute in Houston. Some oohs and ahs would have been nice, but noone said anything.

They stuck the probe up through the femoral artery. It tickled whenever it reached a branch and they had to poke it around to get it to go through.

The entire time, I was leaning up on my elbows looking at the monitor over my right shoulder. It was weird watching them move around and feeling it inside.

Then when they got ready for the barium contrast solution, they made me lay flat on my back. When they injected it, it felt quite warm.

Then they covered me up (finally) and wheeled me back to the hospital room.

Of course, they may have changed it since then.

I didn't have a stent, though. I had an atrial septal defect which they sowed up with surgical steel bailing wire (aka suture) that is still there. I hate metal detectors. I do wonder if I could go through an MRI if it was needed.

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That's fascinating! Was your ASD repair done through the vessel, or open? I had to look it up, and the first repairs through the vessel were done in 1974. They used a huge access sheath and vein cutdown. It's surprising that the device or even sternotomy wires (if you had it done surgically) would set off metal detectors. As to MRI safety, one can't say without seeing a chest x-ray or knowing specifics about the device.

Angiograms have certainly changed in the past 50 years! Devices are much smaller, and can often be done through the radial artery in the wrist. Hell, angioplasty balloons and stents weren't even around then!

OP - a lot of cardiologists do their angios and interventions from a radial approach now. If yours does, there's no restriction to sitting up immediately. You'll have a bracelet with a small balloon that keeps pressure on the artery, and they slowly deflate it. If groin access and they use a closure device, it's usually 2 hours flat. If no closure device, 6 is standard.

Hodor said:

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eric76 said:

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I had a catheterization in July of 1974.

And remember it well.

I was lying on my back on a table, completely nude. And one of the number of people in the room was the best looking nurse I saw in my ten days at the Texas Heart Institute in Houston. Some oohs and ahs would have been nice, but noone said anything.

They stuck the probe up through the femoral artery. It tickled whenever it reached a branch and they had to poke it around to get it to go through.

The entire time, I was leaning up on my elbows looking at the monitor over my right shoulder. It was weird watching them move around and feeling it inside.

Then when they got ready for the barium contrast solution, they made me lay flat on my back. When they injected it, it felt quite warm.

Then they covered me up (finally) and wheeled me back to the hospital room.

Of course, they may have changed it since then.

I didn't have a stent, though. I had an atrial septal defect which they sowed up with surgical steel bailing wire (aka suture) that is still there. I hate metal detectors. I do wonder if I could go through an MRI if it was needed.

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That's fascinating! Was your ASD repair done through the vessel, or open? I had to look it up, and the first repairs through the vessel were done in 1974. They used a huge access sheath and vein cutdown. It's surprising that the device or even sternotomy wires (if you had it done surgically) would set off metal detectors. As to MRI safety, one can't say without seeing a chest x-ray or knowing specifics about the device.

Angiograms have certainly changed in the past 50 years! Devices are much smaller, and can often be done through the radial artery in the wrist. Hell, angioplasty balloons and stents weren't even around then!

OP - a lot of cardiologists do their angios and interventions from a radial approach now. If yours does, there's no restriction to sitting up immediately. You'll have a bracelet with a small balloon that keeps pressure on the artery, and they slowly deflate it. If groin access and they use a closure device, it's usually 2 hours flat. If no closure device, 6 is standard.

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Mine was open heart surgery.

After the catheterization, Dr. Cooley told me that without surgery, I would be dead in five years and the last year of that I would be confined to a bed in a nursing home and would not be able to get out, but with surgery, there was always a chance that I might not survive the surgery. I chose the surgery.

He also said to come back in ten years and they would replace the valve. I never had that done, though.

Years later, Dr. Matsusaki told me that as many miles as I rode a bicycle every year at that time (3,000 to 5,000 miles per year), it would be very clear if I needed the valve replaced.

Six hours laying down flat is a long time. Do they even let you go to the restroom ?

They have a jug for that.

Another benefit, which may not be medically correct, but O seem to have lower blood pressure after the procedure.

FourAggies said:

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One other thing the doctors will probably want is a bad cholesterol number below 50. For me, this meant getting on Repatha. I had been on cholesterol meds for about 15 years and overall had been good around 135 total level. However, a more detailed cholesterol panel showed that my small particle cholesterol was extremely high. Repatha knocked it down to a normal level. I think the late start on cholesterol medicine and not addressing the small particle sizes.

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Read what FourAggies says above regarding the LDL small measurement. It's a very important indicator as the small LDL particles are THE major driver of cardiovascular disease.

Depending on your anatomy, you likely will have a radial artery access rather than femoral, which enables faster ambulation and reduced bleeding risks.

Hey Trout, just curious, who is performing the catheterization at HM?

In July/August of 2024 I started noticing a little "discomfort" in my left armpit whenever I ran up a flight or two of stairs or walked briskly for a while. As soon as I rested for a sec, the issue went away. So I had a nuclear stress test and after I finished the treadmill they guys said oh, you passed no problem everything here looks good, doubt there is anything going on bad with your heart. In my mind I was thinking "Nope, you guys are wrong!". So then they took me over the the CT w/ contrast and found an 80% blockage.

So... in Sept 2024 I had a stent placed by Dr. Duchman at Houston Methodist, through the groin. The prep work was shaving both sides of my chest and both sides of the groin... that was a little weird! I tried watching the monitor during the stent procedure but was in and out of consciousness. The post-surgery rest period was about 1 hour I'd say, not bad at all, and they told me to take it easy for a couple of days.

Had a PFO closure done in October. Similar process to the stint. On your back, nude, lots of drugs to numb everything below your neck. Wide awake. Big tv so the doc can see where they are going. Enter through femoral artery. They put plugs in the incision. Laying there for hours waiting for the bleeding to stop. Had to have a male nurse apply pressure for like half an hour. Weird conversation to have with a man pressing on your junk. Ultimately I went to the ER next day because the bleeding/oozing wouldn't stop and got stitches.

Careful about over simplifying something as complex as cardiovascular disease. Pick whatever metric you want and I guarantee there is some data to support it.

Most coronary caths are done from the wrist via the radial artery these days. This is for patient comfort and safety. The bleeding risk is less, recovery time is faster, and you don't have to lay flat at all afterwards.

That being said, there are some specific reasons or cases that will still be done via the groin/femoral. There are also still quite a few "old school" docs that go femoral all the time.

Typically patients have symptoms (chest pain, shortness of breath, exertional fatigue, lack of stamina) before they get stents so they almost always feel much better afterwards. At times even patients that say they have no symptoms report feeling better afterwards because they learn to "pull-back" or slow down over time without even knowing it. There is a small subset that is truly asymptomatic and won't feel any different after. Depends on the details about how much those stents really help.

Hope your procedure goes well and you feel great after!

TxAger - I went in this morning and was back home at 3:00. Dr. Alpesh Shah performed the procedure. At this time, he didn't see a need for a stent. I believe I spoke to Dr. Shah at some point during the procedure. At least up to this point, no pain, bleeding. The procedure was done via the wrist. I was in the recovery room for about 3 - 4 hours at a slightly elevated angle and pretty much slept after a short visit from my wife.

Dr Shah is a renowned interventional cardiologist and is especially known for his ability to treat complex coronary lesions. You were in great hands, and glad it went well!

Congratulations! Glad it went well.

Glad it went well for you.

I did the same procedure a week ago and they did put a stent. They went through the groin, I guess my doctor is old school. The recovery was 4 hours for me too and it wasn't too bad. I have a follow-up on Thursday and am hoping I can get back to running and lifting weights. I'm curious to hear his thoughts on how long to keep taking blood thinner meds.

I think I'm going to forego the therapy though; the nurse practioner told me that it was simple and some stopped going after the first initial visits.