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Stent Procedures May Be Unnecessary In Some Heart Cases

NEW ORLEANS -- A new analysis by Duke University Medical Center researchers indicates that 1 in 12 implants of tiny tubes called stents to hold open newly unclogged arteries in patients with symptomatic coronary artery disease may be unnecessary.

The arteries were unclogged by an angioplasty procedure in which a tiny balloon is inflated at the site of arterial blockage, pushing the blocking plaque aside and restoring blood flow to the heart. Stents are mesh tubes used to hold arteries open after angioplasty.

The Duke study pooled the results of seven different angioplasty trials and looked at more than 5,000 angioplasty patients. The researchers found that approximately 8 percent to 18 percent of stent implants did not appear to be necessary, especially for men whose vessels had shorter atherosclerotic lesions not involving the top of the artery that feeds the left side of the heart. According to the analysis, a simple angioplasty to clear the blockage appears to work as well as implanting a stent.

"In 1998, more than 500,000 people received stents, and our data suggest that one in 12 may not have required them," said Duke cardiologist Dr. Warren Cantor. "Based on an estimated cost of $1,500 for each stent, the U.S. health care system could potentially save more than $60 million."

Cantor prepared the results of his analysis for presentation Tuesday at the annual scientific sessions of the American College of Cardiology.

The cardiologists looked at those patients who obtained 'stent-like results' from the angioplasty without having had a stent implanted. For the researchers, this meant that the degree of narrowing that persisted after balloon inflation was less than 30 percent without any residual tear in the vessel.

As a part of the study, the researchers also surveyed 133 interventional cardiologists from around the world about how they would define stent-like results, based on visual and radiographic data. As expected, there was
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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
10-Mar-1999


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