3 ms·

I’m not a medical expert but your hand waving of stents feels off to me. Yes, it’s not surprising that stents can be dangerous, but the alternative is open hear

I’m not a medical expert but your hand waving of stents feels off to me. Yes, it’s not surprising that stents can be dangerous, but the alternative is open heart surgery. Which sounds pretty damn risky too. Is the choice really that simple?

redis_mlc 7y ago
I've followed news about stents for decades. They're about $5,000 each. A couple times per year there is some news report similar to this story. I have a feeling that, just like hip replacements took decades to find the right combination of materials to not disintegrate or be rejected, we're still researching what to make stents from and when to use them. The problem is that patients aren't told they're guinea pigs, and stents aren't that reliable. Oh and doctors get to bill a fortune per operation regardless. Regarding this particular story, rather than be outraged, we should have cardiac experts and statisticians sit down and figure out what's real and what isn't. There is valuable data in there somewhere.
- raverbashing 7y ago
  > The problem is that patients aren't told they're guinea pigs Here's the thing. Every patient is a guinea pig in one way or another. Every medication has side-effects both known and unknown. But yeah, maybe stents need to be replaced before 3 years or some better materials need to be found, and maybe they are used in situation where they're not really needed. Still better than bypass surgery which is a very invasive surgery.
- throwawayhhakdl 7y ago
  Ok, but Google says open heart surgery costs $324,000! Which is probably a huge variance number... My point is not that stents > open heart surgery, but rather that they’re not at all easy to compare.
pcj-github 7y ago
Open-heart surgery is certainly no picnic, I'm not suggesting that it is. It depends on who the patient is. If you're talking about an 82yo man with renal insufficiency, that's not exactly a person you're going to rush into surgery. But if you are a relatively healthy 67yo who smoked for a decade but not actively smoking, getting a stent is likely not your best option because your expected life expectancy is still fairly decent. The point is that many people are not getting both sides of the story because cardiologists act as both the gatekeepers and the interventionalists.

redis_mlc 7y ago

I've followed news about stents for decades. They're about $5,000 each. A couple times per year there is some news report similar to this story. I have a feeling that, just like hip replacements took decades to find the right combination of materials to not disintegrate or be rejected, we're still researching what to make stents from and when to use them. The problem is that patients aren't told they're guinea pigs, and stents aren't that reliable. Oh and doctors get to bill a fortune per operation regardless. Regarding this particular story, rather than be outraged, we should have cardiac experts and statisticians sit down and figure out what's real and what isn't. There is valuable data in there somewhere.

raverbashing 7y ago
> The problem is that patients aren't told they're guinea pigs Here's the thing. Every patient is a guinea pig in one way or another. Every medication has side-effects both known and unknown. But yeah, maybe stents need to be replaced before 3 years or some better materials need to be found, and maybe they are used in situation where they're not really needed. Still better than bypass surgery which is a very invasive surgery.
throwawayhhakdl 7y ago
Ok, but Google says open heart surgery costs $324,000! Which is probably a huge variance number... My point is not that stents > open heart surgery, but rather that they’re not at all easy to compare.

pcj-github 7y ago

Open-heart surgery is certainly no picnic, I'm not suggesting that it is. It depends on who the patient is. If you're talking about an 82yo man with renal insufficiency, that's not exactly a person you're going to rush into surgery. But if you are a relatively healthy 67yo who smoked for a decade but not actively smoking, getting a stent is likely not your best option because your expected life expectancy is still fairly decent. The point is that many people are not getting both sides of the story because cardiologists act as both the gatekeepers and the interventionalists.