Stents are being used too much on people who have clogged arteries, according to a recent study. It was discovered that a basic blood-flow test can help ward off nonessential care.
When doctors used the blood-flow test to conclude when these stents were truly needed, less of these diminutive artery props were used, which resulted in less deaths, heart attacks and repeat procedures. The results were posted in the January 15 issue of New England Journal of Medicine.
In past years, there have been reports that have indicated that stents and artery-opening angioplasty procedures were used too much in non-emergency cases, many times without giving medicine time to work. Complications using stents has also caused doctors to be more careful about elective angioplasty.
Although the blood-flow test has existed for years, it is only used in around 10 percent of angioplasties. In the U.S., there are more than 1 million angioplasties performed annually. About half of these cases are of the non-emergency kind like in this study, which encompass people who have two or more heart arteries that have narrowed.
The study, which was performed in the U.S. as well as Europe, consisted of 1,005 people who had chest pains due to decreased blood flow to the heart or who were on the mend from a moderate heart attack, was scheduled for all of the people in the study. An angioplasty was scheduled for all the people involved in the test. During this test, a special dye is injected into the patient’s arteries. The arteries that have narrowed are revealed on an X-ray called an angiogram.
Using only angiograms as a pre-screening measure, angioplasty and stents were used on half of the people in the study. A blood-flow test was used on the other half. During this test, doctors insert a wire into the artery and determine the pressure in forefront and beyond the area that has narrowed. This reveals if a significant amount of blood is being prevented from getting to the heart. In this category of people, angioplasties and stents were used only on narrowed arteries that had serious disruption of blood flow. People who received the blood-flow test got an average of two stents, versus three for the other half in the study.
One year later, a mere 13 percent of the group who received the blood-flow test had died, had a heart attack or needed additional artery treatment as compared to 18 percent of those who were treated according to angiograms alone. After a year, the rates of pain in the chest were shown to be about the same.s