Are Stents Overused?

A recent article in the New York Times by Anahad O’Conner “Heart Stents Still Overused, Experts Say”, states that every year more than half a million Americans undergo procedures to have a narrowed coronary artery propped open with a small thin metal mesh tube (stent). It goes on to say that stenting has been identified as one of the five most overused medical interventions.

Dr. Stanley Lochridge of Cardio-Thoracic Surgeons, P.C. agrees, “This article is pretty much right on.  We do use stents but we also see a lot of overutilization of stents by some specialist physicians.”

Dr. Lochridge continued to explain that some specialists tend to treat the anatomy seen on an arteriogram instead of the symptoms that their patient presents with.

“The use of stents can be reasonable and indicated. They can save patients from having to have repeat coronary bypass surgery by stenting one or two vessels and waiting for more serious blockages before recommending bypass surgery. The problem with stents can be re-stenosis or blockage occurring within the stent. You can also have blockages before and after the stent in the coronary artery. When cardiologists try to remove that scar tissue from the within the stent, it can be a very risky procedure,” says Dr. Lochridge. “We do coronary bypass surgery daily and have seen patients with as many as nine stents. In this situation, it is sometimes difficult to find an adequate artery to bypass beyond all of the stents.”

Dr. Lochridge emphasizes though that stents do play an important role in an emergency situation to treat an evolving heart attack secondary to a blocked or severely narrowed artery to the heart.

Stents are also used in arteries to the brain, legs, kidneys and other arteries about the body.

According to Dr. Lochridge the important thing for patients to remember is that there are options.  Stents are certainly not the panacea or only option to treating blocked arteries. Other options would include medicines, lifestyle changes, and sometimes surgery.