The Daily Observer London Desk: Reporter- John Furner
US taxpayers are spending over $800 million a year on unnecessary heart stents, a report has found.
Stents are tiny mesh tubes inserted into weak or narrow arteries and other passages to keep them open in patients with coronary artery disease, to widen arteries that have become blocked with plaque and keep blood flowing.
The new report estimated that one in five stents implanted between 2019 and 2021 was unnecessary because the patient was not at high risk of a heart attack, the Lown Institute, an independent research firm, found.
At around $10,615 per procedure at Medicare – the federal health insurance for people over 65 – that amounted to $2.44 billion over three years, or $800 million a year.
Stents are tiny mesh tubes inserted into weak or narrow arteries and other passages to keep them open
Dr Vikas Saini, a cardiologist and president of the Lown Institute, said: ‘The overuse of stents is incredibly wasteful and puts hundreds of thousands of patients in harm’s way.’
The report looked at over 1,700 general hospitals across the US and found that more than 229,000 stenting procedures were unnecessary.
The researchers estimated that over 20 percent of stents were placed without being needed between 2019 and 2021.
In the report, stents were defined as unnecessary if patients were diagnosed with coronary artery disease at least six months before the procedure.
Researchers excluded patients who had been diagnosed with unstable angina – chest discomfort or pain caused by an insufficient flow of blood and oxygen to the heart, which may lead to a heart attack – or a heart attack within the past two weeks, as well as patients who went to the ER in the past two weeks.
Northwest Texas Hospital and Riverview Regional Medical Center in Alabama had the highest rates of unnecessary coronary stent procedures, with more than half of their procedures deemed inessential.
Stents may be used to treat narrowed or blocked arteries caused by plaque buildup or coronary artery disease.
Plaque – a waxy substance containing cholesterol – can build up on the inner walls of one or more of the coronary arteries. This narrows the space blood has to travel through.
A substantial amount of plaque blocking the blood flow is known as coronary artery disease.
Stents are placed within a coronary artery during a minimally invasive procedure called an angioplasty.
A patient is sedated, and then doctors make a small incision, often along the forearm or in the leg, close to the groin area.
A thin tube called a catheter is threaded through a blood vessel in the leg and guided until it reaches the coronary artery in the heart that has been narrowed.
The catheter also contains a collapsed stent around a special balloon. When the catheter reaches the stent, medics inflate the balloon, which widens the artery and opens the stent. The balloon is then deflated and removed with the catheter.
The procedure usually costs Medicare $10,615, with the patient paying $1,600 out-of-pocket, the report said.
And patients with private insurance pay more. A 2022 study found that cardiac procedures cost private insurance companies more than $20,000.
Unneeded stents could also lead to complications such as blood clots, abdominal bleeding, kidney damage, heart attack or even death.
Over two million stents are implanted every year in the US.
A 2019 study by Stanford School of Medicine and New York University found that stents were found to have no better effect at treating heart disease than medication.
