It is a procedure now performed a million-and-a-half times a year. Doctors open clogged arteries to the heart with a tiny balloon and usually put in a piece of wire mesh called a stent. But many experts say angioplasties, as the procedures are called, are being done too often and are not always the best way to treat heart disease.
“We’re all looking for the quick fix, and there is no quick fix in this situation," says Dr. Thomas Graboys of the Lown Cardiovascular Center.
There is no question that stenting can relieve terrible chest pains and shortness of breath, but it does not stop the progression of heart disease or reduce the risk of future heart attacks.
Marty Borruso had severe chest pains three years ago and received three stents. But he continued smoking and needed more stents six months later.
'Not a be-all or end-all'
“It’s not a be-all or end-all. You have to make the lifestyle changes to keep things open,” says Borruso.
Dr. Jeffrey Moses of New York’s Lenox Hill Hospital heads a group that performs thousands of angioplasties a year. “We’re treating a problem of a blockage. We’re not treating the whole disease," says Moses.
Many doctors claim that blockages that aren’t causing pain often don’t need to be cleared. For instance, six years ago Ken Goldwyn learned he had three clogged arteries. Graboys treated him only with medication and lifestyle changes.
“I think for the most part, the blockages are still there,” says Goldwyn. “But they have not gotten any worse.”
Experts say before heart patients consider getting the X-ray exam called catheterization that often leads to stents, they should have other, less invasive exams — especially a stress test and echocardiogram — to find out if an angioplasty is really necessary.
And they need to understand that if they do receive a stent, it is a stop-gap measure, not a cure for heart disease.