Angioplasty, Do You Really Need It?

Hey, are your arteries blocked?

Did your doctor tell you that you need a stent or an angioplasty?

It’s unlikely that you need it.

An angioplasty is historically the answer for block arteries.

American Heart Month 2018

Literally, the procedure is performed nearly a million times a year in the United States. But why?

This procedure has risks—significant risks. We’re talking potential heart attack, kidney failure, stroke and bleeding.  And its expensive.  In 2019, Medicare spent more than $10 billion on angioplasties. That’s a lot of money.

They are not the only or best way to address block arteries. Unless you’re in the middle of a sudden heart attack, it won’t prevent future heart attacks any more than inexpensive safe medications.

So, why is the procedure widely used?

Angioplasty Background

Stents came into play more than 40 years ago. There was no research comparing the use of stents to medications. Yet, cardiologists strongly believed this was the best way.

Thankfully, someone decided that trials were needed.

Angioplasty Research: Ischemia Study

Each trial indicated that there is little to no difference in outcomes. But the Ischemia study, in particular, provided solid evidence that stents are no better that medications.

The study followed more than 5,000 patients over a three year period. The evidence was strong. But change is hard. Many advocates of stents say that patients who receive stents have less chess pain. —And that’s just not true. Another study refutes this.

The evidence stacks high.

Patient Consent

If you have a blocked artery, you want it fixed. You trust your provider to inform you of the risks of any procedure. The information can be overwhelming. Sometimes information is left out.

Patients aren’t told or don’t fully understand that there are better options.

What you don’t know or understand can hurt you.

With all the evidence, why do doctors continue to perform these procedures?

Cardiologist and Professor Rita F. Redberg co-authored a study to get answers.

The answers are surprising. Some doctors say patients expect it and it is a part of medical culture. Others fear being sued if they don’t use stents. It’s a tough position to be in.

A doctor is rewarded more for performing procedures. And modern culture says that high-tech solutions are better than old-fashioned medications.

How do we shift this mindset? Will it make a difference?

NCQA and Heart Health

NCQA has HEDIS measures around cardiovascular health. The measures support the use of Statin Therapy, Beta-Blockers, healthy lifestyle changes and other medications.

There are other ways. Angioplasty should not be the only choice. Less unnecessary procedures could save billions of dollars and decrease the risk of harming patients. Patients should know their options. Besides, most people prefer to avoid invasive procedures whenever possible.

 

So, at your next appointment, ask yourself. Do I need an angioplasty?

Because, it’s unlikely that you need it.