Wednesday, March 9, 2011

Risks of Unneeded Cardiac Stents


In my last article about the allegations of unnecessary cardiac stents placed by Westmoreland PA doctors, I discussed the need for increased standardization of medical procedures in Pennsylvania and the United States on whole. I suspect that all across the country, not just Westmoreland PA, many unneeded medical procedures are being performed. Two reasons for this is that many medical procedures are performed at the doctor's discretion and certain procedures carry with them a financial benefit for the doctor and the hospital. Because of this when doctors, like the two from Westmoreland, are suddenly accused of over prescribing we should take a closer look at the system creating the problem before we rush to judge the doctors.

BUT, if these doctors, or any doctors in Pennsylvania for that matter, performed unnecessary stent procedures we must understand the risks the innocent patients now face.

A coronary artery stent is a stainless tube with slots. There is a picture of them in my prior two posts here and here. It is mounted on a balloon catheter in a collapsed state. When the balloon is inflated, the stent expands or opens up and pushes itself against the inner wall of the coronary artery- think of finger cuffs. This holds the artery open when the balloon is deflated and removed. Coronary artery stents were designed to overcome some of the short comings of angioplasty. Angioplasty is a technique that is used to dilate an area of arterial blockage with the help of a catheter with an inflatable, small, balloon at its tip. Although introduced over two decades ago, angioplasty continues to be the most frequently employed procedure in the cardiac cath lab (either by its self, or in conjunction with other procedures such as coronary stenting). Read more about the procedure at www.heartsite.com.

Like any medical procedure coronary stents carry risks to the patient. With coronary stents, it is estimated that the risk of death during a stent procedure is usually less than 1%, while the chance of requiring emergency bypass surgery is around 2% or less. Though rare, stenting poses a risk of a heart attack and bleeding that requires a blood transfusion. However, the risks are relatively low and acceptable in most cases when one balances the potential benefit against the expected risk (risk-benefit ratio). That risk to benefit ratio is the threshold for whether a doctor has committed malpractice by performing an unnecessary procedure.

Probably the biggest risk associated with cardiac stents is the possibility of blood clot formation. In the first year, post-stent, patients are at increased risk of developing a clot due to materials in the blood catching on the stent. Additionally, cardiac stents can lead to an aggravation of kidney function (particularly in diabetics and those with prior kidney disease) due to the large amount of contrast material that is usually required.

If you think you were one of the Westmoreland patients that had an unneeded stent placed and have suffered any of these complications as a result, you should consider contacting an attorney to explore your legal options. Share this post :
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