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Angioplasty – do you really need one?

Angioplasties (stents) have saved hundreds of thousands of lives and have become a part of conventional or perhaps fashionable medical treatment.

Photo credit – Lenore Edman

However, we are also a country where doctors over-prescribe to patients who demand excessive treatment. “A match made in heaven”, which unfortunately is where a lot of us end up, hopefully, but not too soon.

It is no wonder that we pay excessive insurance costs to cover some needless procedures that are sending health care costs skyrocketing. Welcome to the world of heart stents. Every year, more than half a million Americans undergo procedures to have a narrowed coronary artery propped open with a small metal mesh tube, or stent.  The New York Times reported that “the American Medical Association and the Joint Commission said that roughly 1 in 10 elective angioplasty procedures performed nationwide may be “inappropriate,” and another third questionable”. The operation typically costs around $30,000, and in rare circumstances it can cause tears in blood vessel walls, major bleeding and other problems.”

Photo credit – Servier Medical Art via Flickr

Perhaps it is the financial gains that give the doctors and hospitals more incentive to push the procedure? Typically the patient is told that the there is a blockage or narrowing in a coronary and that the stent will alleviate the problem, reducing the risk from the blockage cutting off the blood supply to the heart or from parts of the blockage breaking off and embedding in the blood vessels in the brain causing a stroke.  However, the site that is chosen for the stent is just a small piece of the coronary artery’s “plumbing”.  There can be more plaque built up before or after the stent within that artery.  This is not like having a complete Roto-Rooter job done on the entire artery.  In rare cases stents themselves can cause rupture and tearing of the arterial wall. However, in many cases, the stent gives the patient no more benefit than just taking medications without an operation.  Patients who are undergoing the heart attack and given the option of inserting a stent may not be aware of all the risks and options at the time that they consider that this is their only solution to preventing a future heart attack, certainly not at that moment when they are being wheeled into surgery.

Another approach to consider is prevention — having a diet high in mono and polyunsatureated fats such as nuts, olive oil and fish oil. Also, consider a look at the lifestyle that might bring this problem about. A sedentary life, processed foods, alcohol, smoking, excessive saturated fats, and an absence of a daily exercise program eventually will catch up to you. These are things that are within your control that may prevent the need for going under the knife.

Photo credit – Pedro Alves via Flickr

It is never too late to begin.

These fellows below, a pair of Butterfly Fish, do not need stents. They swim their entire lives. Notice the black spot near the tail that mimics an eye. This is one of their defense mechanisms that can cause a predator to confuse which end is really the head and miscalculate its direction for escape. The Butterfly Fish to the left that is angled away from the camera makes this deception more apparent than the side view of his friend.  Usually these fish are found swimming in pairs. They are very sociable and not afraid of divers.

A pair of Butterfly Fish



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