Physicians, Academics Clash Over Stents

Angioplasty and the insertion of stents are among the more widely accepted and seemingly understood medical procedures, even among laypeople. For instance, my octogenarian mother told me the other day about an acquaintance with a heart condition. "He's only in his 40s, but he's had a stent, and he's doing great. You know, an angioplasty." She's no M.D., but she is conversant in the subject.

But after decades of acceptance, this commonplace surgical procedure is at the center of many heated discussions in medical circles these days. Academics and doctors are clashing over the proper surgical procedures for stents and angioplasties and, even more surprisingly, challenging the fundamental necessity for stents, the "tiny mesh sleeves" designed to keep coronary arteries open.

It's not an open or closed case.

Stents are under the microscope now more than ever, especially with the recent focus on the for-profit hospital chain investigating HCA in the wake of a New York Times report of allegations that some HCA hospitals were performing unnecessary and sometimes dangerous heart procedures with the aim of driving up revenue.

One of the key focuses of the investigation is whether there was unnecessary stenting for patients who did not have significant coronary artery blockage. About 1,200 cardiac interventions that were deemed to be unnecessary were completed at the Lawnwood Regional Medical Center in Fort Pierce, Fla., according to the Times.