A less invasive procedure to open the heart’s clogged blood supply has exploded, the Agency for Healthcare Research and Quality reports.
Percutaneous coronary intervention — also known as angioplasty, balloon angioplasty and percutaneous transluminal angioplasty — is performed when a doctor inserts a balloon-tipped catheter from an artery in the groin to an artery in the heart. The doctor inflates the balloon, compressing the plaque that lines the artery, widening it to increase blood flow. Doctors also often implant a metal stent that keeps the artery open.
The goal is the have the patient’s artery “inflated” within 90 minutes of arriving at the hospital. This is called the “door-to-balloon time” and improves survival rates considerably.
PCI, the agency reports, “is now used nearly three times more often than the older and more invasive coronary artery bypass graft surgery.”
The number of angioplasties from 1993 to 2005 rose from slightly more than 400,000 a year to 800,000 a year.
Heart bypass surgeries rose from 344,000 to 426,000 a year between 1993 and 1997, and then declined to 278,000 a year by 2005.
Although hospital stays in 2005 for angioplasty are much shorter than they were in 1993 (on average 2.7 days instead of 4.6 days), hospital charges have increased by more than 50 percent during the period, rising from $31,300 to $48,000 (adjusted for inflation).
With 1.1 million hospital stays in 2005, coronary artery disease was the third most common reason for hospitalization after childbirth and pneumonia. It was the second leading reason for men, and the seventh for women.
Why should you care?
Because these procedures don’t require surgery and are part of a series of health care standards pushed by the Centers for Medicare and Medicaid and others. CMS ties extra reimbursement to submission of data for its reporting, so most hospitals, looking for extra reimbursement, comply. At some point this information likely will be mandated.
Either way, it’s a click away. Visit www.hospitalcompare.hhs.gov to see how your nearby hospital(s) rate. Take it with a grain of salt, because PCI isn’t for everyone, and meeting the 90-minute window is a work in progress, but it’s still a useful tool.
Jeff Raymond, Medical Writer