Posts Tagged ‘PCI versus CABG’

The is no easy buttonA new headline in Reuters brings home this notion, “Many stent patients get re-hospitalized.”  While this article highlights the high rates of re-hospitalization – (1 in 6! in this study) it fails to mention one of potential culprits.  While the authors discuss increasing patient co-morbidities, they fail to address increasing burdens of coronary artery disease (CAD) in patients receiving stents.  This isn’t a new phenomenon – but the strategy of  multiple stent treatment is. 

In the past, patients with a heavy burden of CAD such as multiple lesions, long length lesions or strategically placed lesions affecting multiple vessels (such as left main disease or trifurcation lesions) were treated more definitively, with open heart surgery (aka ‘bypass surgery’).

However, in the last decade, cardiology has ‘pushed the envelope’ in an effort to treat more diffuse and severe disease with stents and other temporary measures.  Despite multiple research studies showing the shortfalls of this method (as discussed previously here at Cartagena Surgery) this strategy has proved wildly successful with the general public.  Why?

The answer is obvious:  stents are the ‘easy option.’  [compared to surgery].  Too bad one of the other options is death..

multiple stents aka a 'full metal jacket"

Will the latest research (and news headlines) heralding the shortcomings of stents for permanent treatment of serious disease end this trend?

Unlikely.  There is just too much money involved.. and human nature doesn’t change.  Preventable behaviors cause the vast majority of human disease, but our behaviors seldom change.   And people will always seek to press the ‘easy button’.  [note the date on the headline below…]


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