Frequently Asked Questions
Excerpted from recent VDF's Live "Ask the Doctor" Chat with Drs. Rathbun and Cherry, Transcripts of all chats may be found online at www.vdf.org.

Question: How common is it for a stent to close up? If it starts to close up, can it be cleaned out or do the doctors have to put in another stent? How do they get rid of the old one?
Answer: Stents are commonly used for treating PAD. They are great for getting vessels open but may not last forever. In short, stents in the larger vessels tend to last a very long time while stents in smaller vessels tend not to last so long. If your stent is in your pelvis in the iliac artery, it is very likely to stay open for many years. If it is in the thigh or knee region in the femoral artery or popliteal artery, then about 80% remain open after one year. When they do start to close down, we have lots of tools to get them open again.

If someone has a stent that becomes severely narrowed, we usually start with balloon angioplasty. If that doesn't work or if we don't think that is going to work, we have sometimes tried laser therapy, or we use a device that scraps the lining of a vessel in a procedure called an "atherectomy," and sometimes we place another stent (sometimes within the existing stent). It just depends on what your doctor sees on your arterial studies. In some cases, another solution to a narrowed stent is a bypass operation.

Question: Are there any drugs available to dissolve blockages?
Answer: It depends on the type of blockage. If someone gets a blood clot in his or her leg vessels, it can cause sudden pain. For blood clots, we have drugs known as thrombolytics to dissolve the blockage. There is no specific drug for dissolving clogged arteries due to atherosclerosis (plaque). Atherosclerosis causes fibrous-fatty plaques that grow over months to years. These blocked arteries may be tough to manage. We do know that correcting high cholesterol will slow down the growth of these atherosclerotic plaques and in rare cases can even lead to shrinkage (or regression) over time. However, for the time being, we generally use stents or bypasses to manage arterial blockages.

Question: Why does DVT seem to be so common during pregnancy?
Answer: There are a number of reasons why pregnancy increases the risk of DVT. First, female hormone levels change drastically during pregnancy, and these hormones can increase the risk of clotting. Secondly, the weight of the baby often presses upon the veins in the pelvis, slowing blood flow and making them more prone to clot. Finally, after delivery and/or cesarean section, women are often on bed rest, and immobility can promote clot formation.