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Many angioplasty, bypass surgeries are unnecessary: Study 0

QMI Agency

(Shutterstock)

(Shutterstock)

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Nearly one-third of angioplasty and bypass surgeries are either borderline or totally unnecessary, a new study has found.

And while these surgeries clog up the health-care system, some Canadians aren't getting the care they need, say researchers with the Institute for Clinical Evaluative Sciences.

The study looked at 1,625 stable Ontario patients who underwent major invasive surgery in 2006 or 2007 to unclog hardened arteries. Some received angioplasty — putting a balloon into a blood vessel in the heart and inflating it — or coronary bypass surgery — taking a healthy blood vessel from another part of the body and grafting it onto the heart.

Using a list of what they call "appropriateness criteria" to determine whether someone was a good candidate for surgery, the researchers found 18% of surgeries were performed on uncertain grounds, while 14% were totally unnecessary.

Meanwhile, some patients who should have gotten surgery but didn't suffered adverse effects.

On the bright side, the 68% of patients who appropriately received surgery benefited from it.

The researchers say hospitals should all adopt similar criteria for determining who goes under the knife for clogged arteries.

"Our study provides contemporary insights into both the underutilization and overutilization of coronary revascularization practice in Ontario. Crucially, it shows that patients who meet the appropriateness criteria and receive care get better results. This is direct evidence that appropriateness criteria can be applied in clinical practice to improve health care," lead author Dr. Dennis Ko said.

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