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Nearly every day for the past month Roxana Mehran, an interventional cardiologist at Mount Sinai Hospital in New York City, and her colleagues have been getting calls from patients wondering if their stents were really necessary.
Yes, the doctor assures them, they were prime candidates to receive a stent, a small device used to prop open clogged arteries in patients with cardiovascular disease.
Dr. Mehran, who is chair of the American College of Cardiology’s Interventional Council, says she told one such patient, “Don’t worry, I made sure with the physiology test. You were having three to four episodes of chest pain a week. You couldn’t walk two blocks.”
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In a country where 30 million people suffer from cardiovascular problems and over two million die of heart attacks and strokes each year, stents have become essential. Every year, over 200,000 heart surgeries take place in the country. But this demand has stoked a racket of extraordinary proportions: Government data published last month showed that hospitals in Asia’s third-largest economy could be selling stents at margins of up to 654%.
Not any more, though.
Why are so many people agreeing to an expensive procedure — and putting themselves at risk — for a placebo effect?
In his new book, Broken Hearts: The Tangled History of Cardiac Care (Johns Hopkins), David S. Jones ’92, M.D. ’97, Ph.D. ’01, Ackerman professor of the culture of medicine, narrates the history of two of American medicine’s highest-profile treatments for heart disease: coronary artery bypass grafts and angioplasty.
Find out the differences between drug-eluting stents and bare-metal stents, what you should ask your doctor before having a stent placed, and what you should do after you get a drug-eluting stent.
The average person with multiple diseased arteries in the heart does slightly better following coronary artery bypass surgery than after having stents inserted, a new study suggests, but the optimal procedure varies by patient.
Researchers found slightly more heart patients survived at least five years after bypass surgery - 74 percent, versus 72 percent of those who had a stenting procedure, known as angioplasty.
However, people who had no diabetes or heart failure and were non-smokers tended to have better outcomes with angioplasty than with more invasive surgery, the study team reported Monday in the Annals of Internal Medicine.
Not all heart blockages lead to heart attacks. Learn why stents are overused and not always inserted for the right reasons. The 4 questions you need to ask your doctor.
But far too often, studies show, stents continue to be implanted in patients who stand to gain little if any benefit.
But while stents unquestionably save lives of patients in the throes of a heart attack or a threatened heart attack, there is no convincing evidence that stents reduce heart attack risk for people suffering from the chest pains known as stable angina.
The long-awaited study that looked at an inexpensive, non-invasive way to treat the No. 1 killer in America, heart disease, has been completed and it proved that the treatment works.
The latest salvo in the battle over stents -- the tiny mesh sleeves designed to keep clogged coronary arteries open -- came in the form of a study suggesting that the devices are better for some patients than medicines alone.
What DrRich implies with his sage advice is that just because a blockage exists; that we see it visually, does not mean that it needs to be squished open with a metal scaffolding.
A recent study revealed that stents are likely ineffective at relieving chest pain. Why didn’t we know that?
Stents are commonly used for stable chest pain — but the devices may not be helping.
In conclusion, we advocate the use of DCBs in all emergency and routine angioplasty where viable with the use of DES when required
as a bail-out technique only. This is based on a lack of evidence to suggest coronary stents have any implication on mortality, an ongoing
problem (despite advances in technology) with ISR and target lesion revascularisation and promising local data within our trust.
A stent will support the inner wall of your heart's blocked artery, while the angioplasty procedure helps restore blood flow through the artery or arteries that were blocked.
Long after research contradicts common medical practices, patients continue to demand them and physicians continue to deliver. The result is an epidemic of unnecessary and unhelpful treatments.
The new study, published in the Lancet, stunned leading cardiologists by countering decades of clinical experience. The findings raise questions about whether stents should be used so often — or at all — to treat chest pain.
Some doctors say medication can treat mild cases of clogged arteries as well as surgery, while others remain believers of angioplasty procedures called PCIs.
Angioplasty.Org was created in 1997 as a way of celebrating the first two decades of interventional cardiology and to serve as a community, information source and historical archive for cardiologists and other healthcare professionals. We featured original video interviews with renowned physicians and researchers, news and discussion of controversial issues.
However, unlike most physician websites, we decided to remain open and noncommercial. No passwords, no "doctors only" registration, no industry advertisements.
Like angioplasty, coronary stents physically opens the channel of diseased arterial segments, relieves the recurrence of chest pain, increases the quality of life and reduces other complications of the disease.
Angioplasty is often combined with the permanent placement of a small wire mesh tube called a stent to help prop the artery open and decrease the chance of it narrowing again. Some stents are coated with medication to help keep your artery open (drug-eluting stents), while others are not (bare-metal stents).
Stents usually are made of metal mesh, but sometimes they're made of fabric. Fabric stents, also called stent grafts, are used in larger arteries.
Some stents are coated with medicine that is slowly and continuously released into the artery. These stents are called drug-eluting stents. The medicine helps prevent the artery from becoming blocked again.