Treatment of Kidney Stones and Ureteral Stones in Patients with Heart Disease (Coronary Artery Disease or CAD) Who Take Aspirin and Other Blood Thinners (Plavix, Xarelto, Aspirin)
Heart Disease and Kidney Stones
Men and women with coronary artery disease (heart disease) and especially those with history of MI (myocardial infarction or ‘heart attack’) sometimes develop kidney stones.
Patients with heart disease and those who have had angioplasty with drug-eluting stent placed in their coronary arteries of the heart typically have limited options when it comes to treatment for kidney stones and ureteral stones.
Aspirin, Plavix and other Blood Thinners and Treatment of Kidney Stones.
Many patients with heart disease take blood thinning medications such as aspirin, Plavix and Coumadin. While some patients can safely stop these medications temporarily to undergo surgery for kidney stones, many patients cannot stop these medications safely.
Blood thinners complicate decision making for treatment of kidney stones. In particular blood thinners eliminate the option of shock wave lithotripsy as this procedure has a fairly high risk of bleeding complications if performed while taking blood thinners such as aspirin. In this situation ureteroscopy is often the preferred procedure as it can be often performed safely while the patient is on blood thinners or when blood thinners are stopped for a short period of time.
The Challenge of Treating Men with Kidney Stones and Heart Disease
The choices for treatment of kidney stones in men and women who take blood thinners are complex. As a result a very challenging situation arises. In some situations the risk is temporary and if the surgery for kidney stones is not urgent it may be possible to delay it by a few months to decrease the chances of cardiac complications. Medical management can often decrease the risk of the stones growing and getting bigger. These are complex decisions and best decided in consultation between the cardiologist and a urologist experienced in treatment of men and women with complex cardiac problems.
Kidney Stones Should Not Be Ignored.
While the decisions when it comes to treating kidney and ureteral stones in men and women who take blood thinners are complex, treatment should not be delayed and the issue should not be ignored.
Kidney and ureteral stones can cause significant complications if not treated including infection, bleeding, kidney failure.