oh yeah... CT still alive :)

Started by DOCNY81
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Correct me if I'm wrong but doesn't the article says that for some groups it isn't clear if the difference is all that much significant. Anyways stents shouldn't be used for off label indications.
 
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Great article, even the fleas know that the stents are no good long term. This is interesting, even a benefit for CABG in double vessel disease. stents for CAD are dead in the water.

CABG will always be the gold standard.

"interventional" cardiology will be reduced to putting in pacers and a few stents here and there soon, since dx caths will be replaced by CT/MR angio, and educated patients and their responsible physicians will begin to demand CABG. maybe if they are lucky, some family doc will send them a half-dead nursing home patient to do an aortic valvuloplasty on so they can feed their families.

in some ways, the interventional cardiologists are very similar to ER docs- just do a procedure because you "can", then dump them back out of the cath lab for some poor non-interventional cards guy to follow, or more likely a vascular surgeon to fix their screw-ups from hematomas, etc.
 
in some ways, the interventional cardiologists are very similar to ER docs- just do a procedure because you "can", then dump them back out of the cath lab for some poor non-interventional cards guy to follow, or more likely a vascular surgeon to fix their screw-ups from hematomas, etc.

Yeah... The last time an ED guy who put in "a thousand" throacostomy tubes called us about the aberrant choledochostomy tube.

🙂
 
While I see that CABG may be superior to stents in some patients, stents are pretty reliable when used as indicated and for the use they are approved. While I would more than love to see a comeback in CT and the number of CABGs, I also think this won't happen because eventually new and better stents will be developed. There are talks now and even small trials in Europe with bioasorbable stents.
 
the real problem is that the cardioloists are making unilateral decisions to stent patients without obtaining informed consent.

Of course a patient would rather avoid surgery, unfortunately, the therapy is not equivalent. (not yet and probably not in our career life-span)

Patients buy the line of crap from these cardiologists and think stents are as durable longterm and underestimate just what taking plavix longterm means. there is no way that these patients are getting informed consent , esp about off label stenting which is RAMPANT in these cath labs

or all the problems that patients with drug eluting stents face when they need surgery.

trying to get a cardiologist to agree to stop plavix on the chart is tougher than getting an er doc to examine a patient.

i think a patient would be best served by a multidisciplinary approach to guide what is best for a particular set of coronary or vascular lesions, like a tumor board to eliminate the bias
 
CT is DEAD!! everyone stay away like it was the plague!



(more jobs for me and blade👍)