Monday, October 22, 2007

So Much for COURAGE

If a feel-good PR piece for interventional cardiologists, Adolph Bachman, the first angioplasty recipient, was introduced at the Transcatheter Therapeutics Conference (TCT) and told his story about insisting he get another stent, despite what the COURAGE trial suggested:
X-rays showed a new blockage near the site that had been cleared in 1977. Dr. Meier said he told Mr. Bachman it was not serious enough to warrant even a low-risk procedure like angioplasty.

After Mr. Bachman continued to complain, Dr. Meier inserted a catheter into the artery to perform a diagnostic test that showed strong blood flow through the narrowing. The test is one that some doctors think should be more widely used to avoid unnecessary stenting, but Dr. Meier is among the majority who believe it is generally not worth the additional time and cost.

Despite the results, Mr. Bachman insisted on not only getting the angioplasty but on getting a stent inserted. Two months later, he was back at the hospital in need of a procedure to clear a new blockage in the bare-metal stent.
Now we see who's driving the stenting bus...


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