Approximately 1.2 million Americans receive a stent in their heart each year to help open narrowed coronary arteries. So chances are, if you’ve had an abnormal stress test or coronary artery scan, your doctor may have recommended a stent for you too. But is it necessary?
What is coronary artery disease?
Over 20 million Americans walk through life with plaque buildup inside the small vessels that supply blood to the heart. These fatty deposits narrow and stiffen the arteries, making it difficult for oxygen-rich blood to reach all areas of the heart.
Unfortunately, most people have no idea they have coronary artery disease until a significant catastrophic event, such as a stroke or a heart attack, occurs.
What is a stent?
Physicians began using stents in the mid-1980s, primarily to treat individuals having acute heart attacks. During this procedure, called a coronary angioplasty, a tiny, expandable mesh tube is placed in the artery to help keep the vessel open.
Coronary stents quickly became popular for individuals with narrowed arteries, even if they didn’t have a cardiac emergency. It made sense, after all, to open a clogged artery so that oxygenated blood could better reach the heart.
Most metal stents used today come coated with slow-releasing medication to help prevent scar tissue growth in the artery. While bare metal stents still exist, drug-eluting stents (DES) have become the chosen method for interventional cardiologists.
When should a stent be used?
The primary goal of stent placement is to open the blood vessel, theoretically reducing the risk of heart attack and death. Studies show that stents are most useful in emergencies, such as when someone is actively having a heart attack. When an artery becomes completely occluded, a stent helps restore blood flow to the heart, thus saving a person’s life.
Stents may also be helpful for individuals having unstable symptoms from their narrowed arteries. For example, those with frequent or worsening chest pain, also called angina, may benefit from stent placement. In some situations, stents may help to relieve discomfort caused by severe coronary artery disease.
What are the risks of stent placement?
As with all medical procedures, coronary angioplasty with stenting comes with significant risks, including:
- Blood clots
- Bleeding at the catheter insertion site
- Damage to blood vessels
- Re-narrowing of the artery
- Allergic reactions to the contrast dye
- Development of arrhythmias
- Rupture of the coronary artery
- Heart attack
- Stroke
Ironically, some of the possible risks of stent placements are the same things the procedure aims to avoid.
When to avoid stents
There’s no question that stents have saved countless numbers of lives during acute heart attacks. Still, mounting evidence suggests that stents are useless for individuals with stable coronary artery disease.
As a 2020 NEJM study points out, treating patients with stable coronary artery disease aims to reduce the risk of heart attacks and death, all while improving their quality of life. Unfortunately, as the study concludes, stents achieve none of those goals.
Coronary stents do nothing to prevent heart attacks or death in individuals with stable angina. Instead, stents increase the risk of catastrophic events. Doctors who place stents in asymptomatic individuals have taken a stable situation and made it unstable. Stent patients face significant risk during the procedure, followed by a lifetime of dangerous medications.
A large 2019 randomized study of over 5,100 people produced similar results. Study authors concluded that stents are no better than lifestyle changes in individuals with chronic or stable coronary artery disease. Simply put, while stents may be beneficial for reducing symptoms in those with unstable angina, they don’t prolong or save lives. Therefore, individuals without symptoms or with manageable symptoms should avoid stents altogether.
Alternative options for stents
Coronary artery disease impacts all areas of the heart, weakening heart vessel walls and leaving the individual prone to a heart attack. Placing a stent in an area with a tight blockage does not address the underlying issue. In fact, putting a stent in often gives the patient a false sense of security. Sadly, some individuals who receive a stent feel that the problem is fixed and continue living the same lifestyle that got them into the situation in the first place.
The best way to treat severe narrowing of the blood vessels is by holistically treating the entire disease process. By addressing the root cause of coronary artery disease, you have the best chances of improving blood flow to the heart, making the heart more efficient.
Coronary artery disease is primarily a lifestyle disease. Studies show that people can substantially reduce their risk of fatal cardiovascular events by changing how they live. The best alternatives to having a stent placed include the following:
- Consuming an organic, whole-food based-diet
- Increasing consumption of wild-caught seafood and grass-finished meats, including organ meat
- Eliminating sugar, gluten, processed grains, and seed oils
- Exercising regularly
- Spending time outside in the sunshine
- Getting quality sleep each night
- Reducing stress
- Avoiding toxins in the home and workplace
- Improving the quality of indoor air and water
- Surrounding oneself with positive people
Next steps
The human body is remarkable at healing itself, creating many ways to combat the damage it’s exposed to daily. Coronary artery disease is the body’s repair mechanism for inflammation. Messing with this healing mechanism through stent placement may be dangerous.
If your doctor has recommended a stent, please be reminded that this is an expensive and potentially risky procedure, especially if it’s used merely for psychological benefit. Instead, consider working with one of our knowledgeable health providers to gain more clarity about your choices.
Our highly experienced healthcare team uses only the most up-to-date clinical evidence to help you make informed decisions about your health, bringing you that much closer to your 100 Year Heart.
Eat well, Live well, Think well
