Cardiac arteries clogged by fatty deposits are a known health threat which often leads to heart attacks. The Gold Standard of treatment used to be angioplasty – a surgical procedure in which a balloon is inflated inside the blood vessel to flatten any plaque which obstructs the flow of blood. However, doctors soon discovered the cardiac arteries would clog again, requiring repeated angioplasties. The problem with the need for repeated angioplasties was answered by the development of cardiac stents – an expandable wire mesh that can be inserted into a newly cleared cardiac artery to keep it open.
Cardiac surgeons quickly discovered that the use of cardiac stents caused yet another problem – the use of stents can trigger the growth of scar tissue which gradually re-narrows the artery (called restenosis). The solution to this problem, the use of drug-coated stents, was thought to be the final modification to the successful treatment of clogged cardiac arteries. Wrong again!
These new stents are coated with a drug which inhibits healing of the artery adjacent to the stents, thereby preventing the formation of scar tissue, which again occludes the artery. The use of drug-coated stents is big business. It is estimated that 1.4 million people every year get coated stents, which cost $2,300 apiece as opposed to uncoated stents at $700 each. The problem with the drug-coated stents is that they cause “late-stent thrombosis” – the formation of a blood clot inside the stent months, or even years, after the procedure. A recent Swiss study found 3.3 more heart attacks and deaths per 100 with the drug-coated stents than experienced with the uncoated stents. This safety of drug-coated stents has been further called into question by a recent article in the Annals of Internal Medicine.
What do you do if faced with a diagnosis of clogged cardiac arteries? Better ask some pointed questions of your doctor before agreeing to the use of stents.