By Pat Warren

A state commission report shows a drop in the number of stent procedures performed in Maryland hospitals in the wake of an investigation involving a perceived over-abundance of those procedures performed at St. Joseph Medical Center.  Pat Warren reports some think the decline in procedures is related to the investigation.

You may remember how it started.  Hundreds of patients at St. Joseph Medical Center received a surgical procedure they didn’t necessarily need; heart stents designed to open clogged arteries.

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Susan Carrarie of Parkville spoke in a WJZ special report.  She had stents placed in her coronary arteries in two separate surgeries, only to find out they may not have been necessary.

“It just doesn’t seem right,” she said.

And now a report that the number of procedures are dropping leads Johns Hopkins international cardiologist Dr. Jon Resar to believe doctors are taking a second look at stents as an elective procedure.

“The physician who’s doing the catheterization often acts as the gatekeeper and he or she is making that decision at the time of the catheterization and to some extent there’s incentive to put in a stent because there’s additional professional fees that are garnered in that setting,” Resar said.

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And there are patients, too, who often shop around or recommend the procedure even when there are alternatives.

“And again, this is in the elective setting, not when someone is having a heart attack or a threatened heart attack where clearly stenting holds tremendous advantage,” Resar said.

St. Joseph Medical Center issued a statement saying, “It is important to consider patterns of referring physicians and patient choice.  High volume hospitals with good outcomes will attract referrals from a broad area.  And while cases have decreased, high intervention ratios may need to be evaluated but no conclusions should be drawn without patient-specific data.”

At best, the stent investigation may serve to deter that potentially healthy combination of doctors looking strictly at the bottom line and patients looking too hard for an easy fix.

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New treatments may also be contributing to a decline in stent procedures in Maryland and nationwide.