No Extra Benefits Are Seen in Stents for Coronary Artery Disease (Stable Coronary Artery Disease)

NY Times ^ | February 27, 2012 | NICHOLAS BAKALAR

[neverdem]

The common practice of inserting a stent to repair a narrowed artery has no benefit over standard medical care in treating stable coronary artery disease, according to a new review of randomized controlled trials published on Monday.

Stable coronary artery disease is the type of heart ailment that causes angina, or chest pain, after physical exercise or emotional stress but generally not at other times. The review did not include studies of the emergency use of stents for heart attacks.

Stent implantation involves a procedure called percutaneous coronary intervention, or P.C.I., in which a surgeon inserts a mesh tube made of metal into an artery that has become narrowed by accumulated plaque. The tube, threaded through an artery in the leg or arm, expands to hold the artery open at the point where blood flow is restricted.

Some of these devices, called drug-eluting stents, are coated with medicine that helps to keep the artery open. The cost of the procedure varies from about $30,000 to $50,000, and more than one million are performed every year in the United States.

The procedure has certain risks. According to Dr. David L. Brown, an author of the analysis, the risk for death is about one in a thousand, and complications can include stroke, heart attack, bleeding, kidney damage...

--snip--

These results support the current concept of coronary artery disease, the authors wrote — that it is a systemic inflammatory disease of the arteries that cannot be successfully treated by surgical intervention at a particular site on one artery.

According to Dr. Brown, a professor of medicine at Stony Brook University, many doctors cannot accept this. Instead, he said, “interventional cardiologists use the analogy of a pipe blocked in a house — it’s a terrible analogy, but patients accept it. It’s simplistic and erroneous.”

[BwanaNdege]

Amen, Brother!

3X bypass 2003, 3 stents 2010 for me.

BTW, you do know that ischemic heart disease is now considered Agent Orange related, don’t you?

“Good Night, Chesty, wherever you are!”

[RetiredTexasVet]

Once the Food Stamp President and his administration of death get those death panels up and running we will really start to see the number of medical procedures that miraculously become no longer effective or cost efficient. Sort of like “Death Lotto” where the death panels pick random medical procedures to do away with ....

[brytlea]

You know, it just depends, and you can’t always know for certain. This doesn’t seems to be talking about people who clearly need the stent. My father in law had one put in and died because the stent failed. It’s hard to know if he wouldn’t have been better off without the stent, but it appears he would have been.
BTW I’m glad yours is working so well for you. With our experience, if a family member told me they were having one put in now, I would be terrified.