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Should you go under the knife for stents with Angina?

Mar 5, 2012, 9 a.m.

It's a sad fact that unnecessary surgery in the elderly is a common medical practice. Why physicians perform unneeded surgery is a complex question. Sometimes the medical facts are not perfectly clear, and sometimes -- as is the case with stents for Angina -- procedures are commonly bundled together even when they shouldn't be.

Surgery in the elderly is always a serious business. The older the patient, the slower the healing and recuperation process takes. In addition, older adults often react unfavorably to anesthesia. There is also the uncomfortable reality that a different procedure might be required shortly down the road, but spending all of the healing chips in one place just isn't a wise idea.

Having stents put in for stable, non-emergency angina is a common and routine surgery. Stents can save lives during an emergency situation but they are not always the preferred procedure in non-emergency cases. Stents are small tubes that are used to open the arteries of the heart. They are commonly inserted during a heart attack. The stent props open the blocked duct and makes it possible for blood to flow once again. In the case of a heart attack, a stent can make the grim reaper wait a bit longer.

However, stents can also be inserted for stable angina. When the tubes are inserted in a heart disease patient who has stable angina, the positive effects of the stent are less clear than when used in an emergency situation. Stable angina patients must use diet, exercise and often cholesterol medications in order to keep their heart disease under control. Having a stent in one small section of the heart won't prevent the build up of plaque throughout the rest. Stents aren't a replacement for serious lifestyle changes, and the combination of having a stent with the changes is what will ultimately keep the patient healthier for longer.

Part of the reason stents have become so widely used is that they are often inserted into stable angina patients during heart catheterization procedures. Heart catheterization is mainly a diagnostic procedure that is used to determine the health of the heart. A thin tube is inserted via the veins in the groin or arm and then a catheter makes its way to the heart. When it gets there it can be used to just look, clear blockages or to insert a stent. However, stenting is only one of 15 types of procedures that the Mayo clinic uses during cardiac catheterization. This means that there are 14 other procedures that may be more appropriate depending on the patient. Additional diagnostic testing such as a stress test should be combined with the heart cath to determine if stenting is the right solution. However, some doctors stent just in case rather than stopping at the diagnostic catheterization test.

The only real solution when it comes to angina stenting is to stay informed, find an excellent doctor and remember that surgery for the elderly is not the only solution -- so keep an open mind and don't be afraid to ask questions.

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