BY: Richard D. Fox | IN: Medical Malpractice
Modern medicine is always changing, and sometimes new studies show that an established treatment is less helpful than previously believed. Recently, a groundbreaking study demonstrated strong evidence that placing heart stents in patients suffering from stable angina is no more effective than non-surgical treatments. This surprising conclusion could change the established standard of care for this condition.
Angina is a condition in which an insufficient amount of oxygen-rich blood courses through the heart, causing chest pain or discomfort. It is usually a result of a partial blockage in or narrowing of one of the coronary arteries, which bring blood to the heart from the lungs. Especially when the heart is working hard—during physical activity or emotional stress—the obstructed vessels are unable to transport the necessary blood flow with the necessary expediency. This condition is called “stable” if it has a regular pattern (how often it occurs, how severe it is, and what factors trigger it, e.g., exercise or stress). The pain of this kind of angina usually abates with rest or medication, but it signifies a potential for future heart attacks. “Unstable” angina, on the other hand, does not correlate with an apparent cause and is difficult to treat or predict; this is an escalation of the condition that corresponds to a higher chance of heart attack.
For decades, one of the most common ways to treat stable angina has been to perform surgery, called percutaneous coronary intervention (PCI) or coronary angioplasty, and insert a mesh tube called a stent into the blocked or narrowed coronary artery. The stent supports and holds open the vessel, allowing increased blood flow through the heart. This simple procedure seems to make sense, logically; improving blood flow should alleviate the pain caused by poor blood flow. Patients who received stents reported feeling better and experiencing less pain, and they seemed to be healthier following the surgery. As a result, the procedure became a standard treatment for the condition; hundreds of thousands of them are performed in the U.S. each year.
While it is well-established that PCI is a life-saving procedure for patients suffering from acute myocardial infarctions (heart attacks), new evidence shows that for patients suffering from stable angina, a stent may not be the best choice. The surgery itself has risks; about one in 50 patients suffers a serious complication or dies as a result of the implantation procedure. The medications patients must take following the implantation have side effects and risks, and taking them can impact other health conditions or potential treatments the patient may need.
Most importantly, implanting a stent may not have significant advantages over non-surgical treatments for stable angina. In a landmark double-blind study (i.e., where both the patients and their doctors did not know which patients were getting a stent and which were not), the treatment outcomes for both groups were essentially indistinguishable. The stent group and the control group reported similar reductions in symptoms and performed similarly on physical tests and health evaluations conducted some weeks after the surgery.
There are many non-surgical treatments for stable angina that demonstrate good results without the risks and potential complications of surgery. They include taking specific antianginal drugs, which alleviate symptoms and support heart function, alone or in combination with aspirin, which reduces blood clotting; nitrates (like nitroglycerin), which relax and widen blood vessels; beta blockers, which block the effects of epinephrine (also called adrenaline) and reduce blood pressure; statins, which lower blood cholesterol; calcium channel blockers or antagonists, which relax and widen blood vessels and slow your pulse; and angiotensin-converting enzyme (ACE) inhibitors, which help relax blood vessels. Lifestyle changes like quitting smoking, getting more exercise, reducing stress, losing weight, and improving your diet can have a significant impact on daily symptoms as well as long-term outcomes.
It can take a long time for medical practitioners to stop using techniques or treatments that are no longer recommended. According to a 2011 study, only about half of the stents implanted to treat non-acute or stable angina would be classified as medically appropriate. Unnecessary and potentially harmful surgeries increase the risk of complications, medical device failures, medical mistakes, and other side effects that can cause injury and even death.
If you’ve been injured as a result of a stent or other medical device, you may be able to recover money damages for your injuries. Please contact the experienced medical malpractice attorneys at Sommers Schwartz to schedule a consultation today.
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Richard Fox handles personal injury cases, including birth trauma, medical malpractice, and motor vehicle negligence. Throughout his career, which has spanned over 45 years, Rick has successfully represented clients in medical negligence and other personal injury claims.