Drug-eluting stent makes knee surgery a no-go for now
DEAR DR. ROACH: I need an objective opinion. I’m an active 75-year-old male who had two drug-eluting stents placed in my heart approximately seven months ago. I have noticed no difference. I have low blood pressure and feel just fine. As a result of the stents, I have been taking 90 mg of Brilinta twice a day since the procedure. Recently, an old injury to my knee flared up, creating a great deal of pain and discomfort. It has not gone away as it usually does.
My orthopedist ordered a CT scan that showed I have a complex tear in my medial meniscus that needs surgery to repair. Even though I am in pain, unable to walk without a cane and suffer throbbing pain in my knee at night, the orthopedist will not operate unless I come off the Brilinta five days prior to the surgery. My cardiologist refuses to agree to succession of the Brilinta with what I consider a cavalier attitude, and offers no alternative suggestions. — G.N.
ANSWER: I understand your frustration, and I hope I can explain why your cardiologist and orthopedic surgeon may have the positions they do.
The stent is a metal device that holds open an artery after it has been unblocked. Some stents are bare metal, but a drug-eluting stent has medication that slowly dissolves over many months, to help keep the blood from clotting inside the stent. A clot often leads to a heart attack and may lead to death.