Heart Stents “Highly Overused,” Say Experts

A breakthrough coronary procedure that has saved the lives of many, coronary stints are implanted in more than 500,000 Americans who have been diagnosed with narrowed coronary arteries. However, studies indicate that many patients may receive a stint when the procedure offers little to no benefit.

Stent placement, formally referred to as angioplasty, was listed in a report issued by two leading medical institutions that named five commonly overused medical procedures. The report focused on elective angioplasty procedures that were performed in patients who had stable coronary disease, a condition through which patients may generally experience chest pain and discomfort only after physical exertion. Research findings suggest that patients with stable coronary disease often do not receive additional benefit from stent placement when compared to using medication to prevent heart attacks.

According to the American Medical Association and the Joint Commission, approximately one in every ten elective angioplasties may be inappropriate, while an additional one-third of all elective stint placements may be questionable. While complications are not common, cases in which the procedure results in tears in the blood vessel may have severe outcomes, and the financial cost of the operation is around $30,000. Some experts believe doctors may be motivated to perform elective angioplasty procedures for financial gain and an increased revenue stream for the hospital. However, others believe unnecessary procedures may be performed simply as the result of a misunderstanding of the nature of coronary disease among doctors and patients.

The report noted that implementing tools like random case reviews and standardized reporting may reduce instances of unnecessary angioplasty surgeries. The report also argued that a greater emphasis should be placed on informed consent and full disclosure of the benefits and risks of the treatment before a patient elects to have the procedure. By doing this, patients and families may have a better idea of the possible outcomes that may arise from having the surgery. Dr. Rothberg, who conducted a small study that was published in The Annals of Internal Medicine, offered the suggestion that doctors may be oversimplifying when explaining the nature of coronary disease and the role of medication to their patients, leaving the patients to conclude that the issue is simply a matter of correcting the blockage.

Read more at: http://well.blogs.nytimes.com/2013/08/15/heart-stents-continue-to-be-overused/?_r=1