- More than one in five coronary stents was not necessary between 2019 and 2021
- This cost Medicare more than $2.44 billion, the Lown Institute found
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American taxpayers spend more than $800 million annually on unnecessary cardiac stents, a report has found.
Stents are small mesh tubes inserted into weak or narrow arteries and other passageways to keep them open in patients with coronary artery disease, widen arteries clogged with plaque, and keep blood flowing.
The new report estimated that one in five stents implanted between 2019 and 2021 were unnecessary because the patient was not at high risk for a heart attack, the Lown Institute, an independent research firm, found.
At about $10,615 per procedure with Medicare – the federal health insurance for people over 65 – that amounted to $2.44 billion over three years, or $800 million per year.
Stents are small mesh tubes inserted into weak or narrow arteries and other passageways to keep them open
Dr. Vikas Saini, cardiologist and chairman of the Lown Institute, said: ‘The overuse of stents is incredibly wasteful and puts hundreds of thousands of patients at risk.’
The report surveyed more than 1,700 general hospitals in the US and found that more than 229,000 stent procedures were not necessary.
The researchers estimate that between 2019 and 2021, more than 20 percent of stents were placed without necessity.
The report considered stents 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 insufficient blood and oxygen supply to the heart, which can lead to a heart attack — or had a heart attack within the past two weeks, as well as patients who had the went to the emergency room in the past two weeks.
Northwest Texas Hospital and Riverview Regional Medical Center in Alabama had the highest rates of unnecessary coronary stenting procedures, with more than half of their procedures deemed nonessential.
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 the blood has to travel.
A significant amount of plaque blocking blood flow is known as coronary artery disease.
Stents are placed in a coronary artery during a minimally invasive procedure called angioplasty.
A patient is anesthetized and then doctors make a small incision, often along the forearm or in the 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 in the heart.
The catheter also contains a collapsed stent surrounding a special balloon. When the catheter reaches the stent, doctors inflate the balloon, widening the artery and opening 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 heart procedures cost private insurance companies more than $20,000.
Unnecessary stents can 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 US every year.
A 2019 study from the Stanford School of Medicine and New York University found that stents appear to be no better at treating heart disease than medications.