Why All the Fuss About Unnecessary Stents? A Basic Primer of Stenting Risks

Published on Aug 1, 2014 at 3:37 pm in General Blogs.

Ordinarily, the benefit of receiving a cardiac stent far outweighs the risks of stent surgery and the necessary postoperative treatment. There are however sizeable risks to consider if you are fortunate enough to have the time and accurate information about your condition to do so. Recently, more than 500 patients at St. Joseph’s Medical Center in Towson, Maryland were advised they may have received cardiac stents unnecessarily and to consult with their private physicians. These patients didn’t have the time to realize they didn’t need the stents to begin with and are now faced with questions about their medical future.

Stents when needed do save lives. They are deployed to open clogged arteries and allow greater blood flow to the heart. The need for a stent is based in part on the level of occlusion or interruption of normal blood flow in the particular vessel at issue. Some vessels are primary and are thus critically important to the heart’s vitality and need good blood flow at all times. Other vessels are secondary or “collateral” and a blockage there is less significant and often requires no treatment.

Approximately 30 percent of stent patients form scar tissue around the stent. Over time, the scar tissue captures plague that flows naturally through the vessels and is what usually has caused the clot formation necessitating the stent placement. Studies have show that a second clot or blockage is more likely to occur at the stent site than in other portions of otherwise smooth vessel. Many interventional cardiologists who perform stenting procedures now use a “drug eluting” stent, which slowly emits a drug over time to prevent or diminish the scarring and clotting that may occur at the stent site. Because these drug eluting stents are relatively new to the market, the long term consequences to patients is uncertain. Indeed they are FDA approved, but as we have seen in other drug recall cases, FDA approval does not guarantee safety.

A clot that forms in a vessel may travel to the lungs or the brain and cause an embolism or stroke. These events are frequently life threatening and can, at minimum, change significantly the quality of a patient’s life. Patients usually are prescribed blood thinning agents such as Plavix ® after stent surgery to prevent clots and stroke. Again, although FDA approved, the long term use of such drugs may cause complications and may interfere with the need for emergency surgery should that become necessary. Surgeons must deal with those on blood thinners and must take emergency action to normalize the patient’s coagulation factor before operating. Otherwise, a patient may bleed to death on the operating table.

Allergic reactions have also been reported following stent surgery. One study conducted by researchers at Northwestern Memorial Hospital found instances of reactions to the polymer used in the stents and reported instances of severe complications and death. An allergic reaction such as those reported may require premature discontinuance of the anti-coagulation drugs such as Plavix®, which can cause other complications.

Weill Cornell Medical College has an excellent online resource for questions about stents. We encourage our readers to review that site and its references for further information.

The lawyers at Belsky, Weinberg & Horowitz, LLC are representing individuals with claims against St. Joseph’s Medical Center and Dr. Mark Midei.



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