Q: I am 55 years of age. I had two blockages in LAD 75% stenosis at the origin of D1 PTCA (2.75 X 18 mm cypher stent implanted) and RCA 20% stenosis at the mid segment. Now, I am getting pain again. So I contacted a doctor who said that the stent may not be functioning properly. With his advice a stress test was done which was positive. The conclusionis: Significant ST segment depression seen during the test in inferior leads after 10 1 METS and at 100% THR; significant ST depression of 1 mm or more (over and above that presentwith voluntary hyperventilation) was recorded in leads II,III and AVF, V4, V5 and V6. What can be done if the stents are not working? Can they be replaced? I am taking T-Ecosprin, Clopigrel, Valent 40 mg, Stmlo 5 mg, Tonact 20, Nialip 375 mg, Racifer and my BP is 80/130.

A:I am afraid your symptoms are suggestive of recurrence of angina and if your stress test is positive then you are obliged to undergo a second coronary angiography to see whether this stent is functioning or blocked and what can be done further. Some times, there may be additional blockages which may be new ones and therefore they may need to be dealt in their own right. It is possible to restent a blocked stent but then all these decisions can be taken only after the coronary angiography has been performed. Generally if a cypher stent has blocked, my personal advise is to go for a bypass surgery the second time as the human bodies tendency can vary from individual to individual and it’s possible that your internal environment of the body is such that such stents are prone to blockage. In any case, the reblockage rate in a medicated stent is also close to 10% so it’s not that they are 100% fool proof. The stent is not replaced but a new stent is deployed, if one decides to go for second time stenting. I hope I have answered your queries to your satisfaction but if you have any further doubts, please feel free to contact us.