- More than one in five coronary stents between 2019 and 2021 were not necessary
- This cost Medicare more than $2.44 billion, the Lown Institute found
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American taxpayers are spending more than $800 million a year on unnecessary heart stents, according to a report.
Stents are small mesh tubes that are inserted into weak or narrowed arteries and other passageways 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 having a heart attack, the Lown Institute, an independent research firm, found.
In Medicare, the federal health insurance for people over 65, about $10,615 per procedure, this is equivalent to $2.44 billion over three years, that is, $800 million a year.
Stents are small mesh tubes that are inserted into weak or narrowed arteries and other passageways to keep them open.
Dr. Vikas Saini, cardiologist and president of the Lown Institute, said: “Overuse of stents is incredibly wasteful and endangers hundreds of thousands of patients.”
The report analyzed more than 1,700 general hospitals in the US and found that more than 229,000 stenting procedures were unnecessary.
Researchers estimated that more than 20 percent of stents were placed unnecessarily 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.
The researchers excluded patients who had been diagnosed with unstable angina (chest discomfort or pain caused by insufficient flow of blood and oxygen to the heart, which can lead to a heart attack) or a heart attack in the past two weeks. , as well as patients who attended the emergency room in the last two weeks.
Northwest Texas Hospital and Riverview Regional Medical Center in Alabama had the highest rates of unnecessary coronary stent procedures, and more than half of their procedures were considered non-essential.
Stents can 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 coronary arteries. This reduces the space through which blood must travel.
A substantial amount of plaque blocking blood flow is known as coronary artery disease.
Stents are placed inside a coronary artery during a minimally invasive procedure called angioplasty.
The patient is sedated and then doctors make a small incision, often along the forearm or leg, near the groin area.
A thin tube called a catheter is passed through a blood vessel in the leg and guided until it reaches the narrowed coronary artery of the heart.
The catheter also contains a stent collapsed around a special balloon. When the catheter reaches the stent, doctors inflate the balloon, which widens the artery and opens the stent. The balloon is then deflated and removed with the catheter.
The procedure typically costs Medicare $10,615, with the patient paying $1,600 out of pocket, according to the report.
And patients with private insurance pay more. A 2022 study found that cardiac procedures cost private insurance companies more than $20,000.
Unnecessary stents could also lead to complications such as blood clots, abdominal bleeding, kidney damage, heart attack, or even death.
More than two million stents are implanted in the United States each year.
A 2019 study by Stanford School of Medicine and New York University found that stents have no better effect in treating heart disease than medications.