Research Asks: Do Stents Fall Short?

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.

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.
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  • Jonathan LaPook

    Dr. Jonathan LaPook is the chief medical correspondent for the CBS Evening News. Follow him on Twitter at @DrLaPook