Research Asks: Do Stents Fall Short?

CBS Evening News: Recent Data Questions Benefits Of Some Stents To Treat Heart Disease

(CBS)  Stents are the tiny springs used to prop open clogged arteries. About 900,000 stent procedures are done every year in the United States. It's the most common heart surgery of all. But it's expensive and sometimes unnecessary.

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There's more evidence that doctors need to keep an open mind about closed arteries, CBS News medical correspondent Jon LaPook reports.

"You would think that if your artery was narrowed or blocked, getting rid of the blockage would make everyone better. But sometimes those simple truisms aren't so true," said Dr. Steven Nissen of the Cleveland Clinic.

What is true is that using balloon angioplasty to open a clogged artery and then adding a stent to keep it open can save a life if done within 12 hours of a heart attack.

But recent data has questioned the benefit of inserting stents later than 12 hours. And Wednesday, a study shows that over time, medical therapy - using only drugs - is $7,000 cheaper and offers the same quality of life as putting in a stent, which can cost in the tens of thousands of dollars.

"Clearly, in many clinical situations, medical therapy may be as good therapy as angioplasty," said Dr. Ralph Brindis of the American College of Cardiology.

And for patients with the most serious blockages, the standard of care has been bypass surgery, where doctors use a patient's own good blood vessels to divert blood around areas of narrowing.

A second study examined a recent trend in cardiac care: the idea that putting in lots of stents could work just as well as bypass. Again, stents fell short.

"Over time, many of the patients that had stents are coming back for another procedure whereas quite few of the bypass patients are coming back for another procedure," Nissen said.

As LaPook reports, one clear message here is that size doesn't fit all. Stents definitely have a role in the treatment of heart disease, but it seems that role is more limited than once thought.

[toolmangler-2009]

July 10, 2004. I went to the emergency room with what I thought was a severe case of acid indigestion, they took one look at me and rushed me into the exam room on the double. I died then, fortunately I was in the one place where they could bring me back. End result, 4 stents and therapy plus 12 (now 5 meds) gave me a second chance. For that I am very greatful. The stents work great for me and I went back to work til I retired (and I still work part time).

[timothyone-2009]

A stent that caused scars that blocked my coronary artery did more damage to my heart than several previous heart attacks did. The stent caused the only serious damage to my heart, and I may be in much better shape if I had never had it inserted. Medicine and bypass are the way to go.

[brainteaser2]

The choice of treatment now is either medical therapy which works - it carries with it the probability that the disease will come to an abrupt painless end (cardiac arrest) VS. Bypass grafting and one can watch themselves slowly deteriorate year by year with death from heart failure. For some the question of quality of life is a major issue.

[catwoman1952]

rnbwprsm5.....Whatttttttt

[catwoman1952]

We don't need government control, we need to people to be responsible for themselves. Unfortunately our health system is flooded with people who have destroyed their own body, then they want a quick fix.

I made mistakes and I take full responsibility for the shape my health is in now. I also changed, people can do that. It just seems that all anyone wants to do is be angry at someone else...get angry with yourself and take of yourself!

[catwoman1952]

I had a stent procedure done in 2002. It dramatically helped my symptoms. If I had waited I would have had a heart attack..
People forget that everyone is different and each cardiologist has to provide for the patient in front of them. Being angry at pharmaceutical companies and insurance companies is not going to fix this problem. Everyone must be "the Captain of their own ship" and take responsibility for keeping oneself healthy. I believe the problem is the individual. They live a life full of bad food, no exercise,smoking and doing drugs, then when something goes wrong they have to blame someone else. Time to stand up and be responsible for your long term actions regarding health.

[dumdnc]

idnnsg-yep, and the government wants mo money, mo money, mo money. The government wants to punish those that do well and reward those who do, well, nothing.

[dumdnc]

Not to worry folks, soon we'll have nationalized health care that will ration procedures such as stents and open heart surgery. So, hail the chosen one and the government control of our entire lives. Why, we will finally have utopia, no responsibility for our actions.
My only question is, where will the Canadians go for health care??? They come over for testing, surgery, treatment.
tomineaston-yep, you are right. Diet, exercise, no smoking, drinking, taking illegal drugs would prevent many of our health problems. Here's the issue-that means we would have to take responsibility for our actions and that is something the libs don't want!! Just how can the medical industry MAKE someone take responsibility for our lifestyles. More government control???? It's a very complex issue and one that I don't want the government meddling. My God, the likes of pelosi and reid, scary at best.

[idnnsg]

"I'd like to know why the medical industry insists on maintaining focus on alleviating the symptoms, when it is safer and cheaper just to solve the problem."

In a capitalist society, the primary goal of every industry is to make MO' MONEY! Solving problems doesn't make money. Life-long, ineffectual treatment of problems makes MO' MONEY!!! (and MO' MONEY, and MO' MONEY, and MO' MONEY...)

[lochlan-2009]

"a study shows that over time, medical therapy - using only drugs - is $7,000 cheaper and offers the same quality of life as putting in a stent, which can cost in the tens of thousands of dollars."

Of course, it's only your life. So, let's go the cheap route and get what we pay for. Is this article to reinforce the insurance companies denying stents in favor of pharmaceuticals?

[walt1944-2009]

Two Years ago, my wife had 3 stents put in on 2 different stays within a month of each other in the hospital.

They didn't improve her life at all, though they improved the hospital's and doctor's financial situation thanks to medical insurance.

Ultimately, she ended up with a triple bypass which did help her a lot, but cost mega-bucks and, again, improved BOTH the hospital's and doctor's financial situations thanks to medical insurance.

So why did they do the stents in the first place???

I have always believed that doctors and hospitals look at the patient as a "reasus monkey" used in experiments, instead of human beings and that it doesn't matter to them if their "procedures" work or not, so long as the insurance or YOU, PAY and PAY and PAY!!!

HAIL OBAMA!!!

[skeezix06]

Stents aren't used solely on the heart. I can't help but think that promoting medications to solve the problem benefits the pharmaceutical companies and insurance companies, both powerful lobbies.

[suprsport68]

My mom just got a stent for a 90% blockage. The stent was 798.00. Haven't received a bill for the hospital stay which I'm sure is under 10,000. It was not improved her quality of life at all. In fact she is more short of breath now than before.

[tomineaston]

Literature that I have read from Drs. Campbell ("The China Study"), Esselstyn ("Prevent and Reverse Heart Disease"), and McDougall ("The McDougall Program for Maximum Weight Loss") presents some pretty convincing evidence that following a low-fat, oil-free, low-sodium vegan diet will not only arrest, but in some (maybe many) cases reverse, atherosclerosis--essentially, preventing any chance of a heart attack. I find it curious that medication is presented as being $7,000 cheaper than the stent treatment (at $20,000!), when the problem can be avoided altogether simply through following a simple diet (at a cost of $0).

I'd like to know why the medical industry insists on maintaining focus on alleviating the symptoms, when it is safer and cheaper just to solve the problem.