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Angioplasty: mostly hot air
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A recent study and editorial in the Journal of the American College of Cardiologists (19:946-7) casts doubt on the entire concept of coronary angioplasty, that recently developed technique, now more popular than coronary artery surgery, in which a ba

A recent study and editorial in the Journal of the American College of Cardiologists (19:946-7) casts doubt on the entire concept of coronary angioplasty, that recently developed technique, now more popular than coronary artery surgery, in which a ba

According to the study, which measured the degree of stenosis (artery clogging) in patients before and six months after angioplasty, in a large number of patients, doctors administering coronary angioplasty grossly underestimate the degree of constricted arteries of their patients or the percentage who will go on to get arteries clogged up again. Even the most experienced cardiologists tended to overestimate the degree of severe stenosis and underestimate the degree of mild blockage. According to the study, the degree of error could be as high as 189 per cent.

Most surprising of all was the discovery that coronary angioplasty doesn't really improve matters much. Although the average narrowing of coronary arteries before the procedure was 61 per cent, the average diameter was only 0.45 mm wider six months after the procedure. This translates into only a 16 per cent increase in diameter.

The editorial also points out that dietary and drug management might be better alternatives particularly when only 17 per cent of patients were offered them as alternatives.


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