Do You Have An Iliac Artery Stent?
Image and copyright purchased from ShutterStock
A little Anatomy training could be helpful.
Iliac artery stent:
In the image above, identify your aorta, and the common iliac, internal iliac (hypogastric), external iliac and femoral arteries. Imagine where your stent might be. Ask your doctor for a copy of your scan; it’s your property. Understanding your body and your stent might just save your life one day.
Here’s my common, internal and external iliac stent complex (three, in fact). The original Cook Zenith Stent Graft, in 2010.
Can you see the Cook Zenith original stent, and the stent in the branches of the internal and external iliac arteries? It’s not magic. It’s just anatomy.
One in 2013, due to an unavoidable bike wreck (unless I stayed at home in a lazy boy; bad idea with aortic disease).
The other in 2017, due to a kinked stent extension, blocking and clotting my common iliac artery completely closed (no pulse but I still have my leg. Why? Collateral circulation, built up over a life-time of exercise; see image at the bottom of the post). There’s a third stent, inside the common iliac, keeping it open and stabilizing the link between the Cook Zenith and the stent extension, thanks to Mark Farber and his great team at UNC CH.
When I discussed cycling after the 2017 repair, Mark agreed that I should minimize hip flexion on the bike (no more aerobars!).
As I swim, bike and run, I think about these remarkable devices, and how not to mess with them.
Today I was riding the trainer bike, and had a thought, but on reflection it may be incorrect. Watch this short video and think about what I’m saying.
Should I rotate my pelvis along with my legs, to minimize movement around the hip joint. This will result in movement around the region of the sacroiliac joint, exactly where my stent machinery is situated.
OR
Should I keep my pelvis stable (how I normally ride), and rely on the flexibility of my femoral arteries to minimize stent movement, and potential dislocation? I think this is the correct answer! You?
Like the famous Ginsu Knife, there’s more.
Interaction with muscle groups.
Should I minimize use of my gluts, so as to reduce jiggling of the internal iliac extension. Too much movement could disturb it’s link to the common iliac extension fenestration (window).
OR
Sit back in a lazy boy recliner, with a book in one hand and a whisky recommended by that great man, Andrew Weil in the other?
I sure wouldn’t use that recliner, it could trigger my NFP (‘plantar fasciitis’) issue, as Tom’s research has shown.
Need to think about that, too!
Think about the relation of your stent to both soft and hard (bones, ligaments, tendons and joints) tissues. Image by Mikael Häggström.
My choice: to keep right on thinking and training. It doesn’t matter so much whether I’m right or wrong, as long as I do the best I can to work out what is safe. Each body is different; for instance, I have a short left common iliac artery (1.5 cm.)
A life without risk is no life at all.
Oh Yes! See if you can persuade your doctor to put this picture on his office wall, please:
Grey is muscle, white is fat, clear ring around the central white spot (bone marrow) is the femoral bone.
I just received my third iliac stent. I had a clotted internal iliac artery on my right. Have good collateral circulation so no problem there. What happened was I showered clots to my foot. Lost all pulses to the right foot. Numbness ensued. Saw Dr. Jason Lee at Stanford University. We tried to place a stent in the right common iliac artery to prevent pieces of the clot in the internal iliac from breaking off and traveling to my foot. The stent was to act as a wall keeping the clot from entering into the common iliac. Kind out of the boxes as far as stent function. Problem was the stent migrated up and blocked off my left iliac artery. Just this past weekend he placed a small metal stent on the right to push the original stent “up” to open the right artery. I’m at a point that I just wish I had done nothing. Take the risk that more clots might break off and embolize my foot. Might seek another opinion.
Sorry for the delay, Will, I was busy with the flu and a dry socket after an extraction, all this got me discombobulated, not to mention messing up my training.
Boy, your case is a tricky one. I just had a completely occluded left common iliac artery due to a stent kink at the point of a stent extension links into the common. Training resulted in plenty of collateral circulation, so I still have both feet. They reopened the stent and put a stent inside that to keep it open, which has worked for over a year.
You must be having a hard time with this business.
I think we just have to deal with one thing at a time. Foot numbness is a pain, as I get it if I have any impact when running due to PAD. It’s always a puzzle working out how to move on.
I’m impressed that you sound positive about it all.
If I can help please let me know. I can be reached at olddogintraining@gmail.com
Once again, sorry for the delay.
Kindest regards,
kev