Find yourself regularly drooling over junk food, yummy chicken, that heavenly Butter Chicken, Baingan Ka Bharta, Hyderabadi zaffrani Pulao, Chicken Tandoori, Pav Bhaji,….the list is quite endless and so is the drool factor!

But as we all daydream about eating the above mentioned delicious dishes that make our palate go into overdrive, do we ever give a thought as to WHY? Why is that we love Indians love our butter chickens, Tandoori Chickens, Pav Bhaji’s so much. Never right! So, a group of scientists from the Deakin University, Sydney conducted a research on why we as humans are so fond of fatty foods and found out that apart from the normal five tastes that our tongue can detect - sweet, salty, sour, bitter and umami – a unique protein rich taste which is found in soya sauce and chicken stalk, our tongues can also detect the taste of fat!

To prove this, the researchers conducted a test on a group of 50 people and found their ability to detect fat was linked directly to their weight! The study found that people who were sensitive to this taste of fat were inclined to consume less of it and thereby had a lower BMI (Body Mass Index) while those who were insensitive to this taste were found to consume more fatty foods and had larger waists with a higher BMI as compared to their ‘fat’ sensitive counterparts!

According to Russell Keast from Deakin University, we have so many fatty foods easily available now-a-days, that we have become de-sensitized to the taste of fat! Due to which he adds that, “We all like eating fatty foods. What we speculate is (that) the mechanism is to do with stopping eating. Your body is able to tell you you’ve had enough and stop,” he explained. “And if you are insensitive to it i.e.fat, you’re not getting that feedback.”, this simply means that with our taste buds being de-sensitized we are not getting the required feedback of when to stop and are this is leading to over-eating and ultimately poor health!

Now this should explain why we end up gorging on the Pav Bhaji’s and Hyderabadi Zaffrani Pulao’s every time they are placed in front of us!

From Biscuits, Cooking Oil, Instant Noodles, Toothpaste, Chewing Gums...there are one too many advertisers in India, attaching the word - Health, Healthy,without any responsibility. In fact, if you visit McDonalds, even their  table pamphlets talk about health with great prominence!

Ads which claim that a change in cooking oil can help your kid pass with flying colors in the exams. Biscuits which make you lighter and more energetic.Toothpastes with Namak, which can help you prevent toothaches. Most of these claims are completely questionable.

Advertisers abroad, need to prove their health claims for their products. They go through rigorous approvals, before they can proclaim anything as healthy - whereas we are in a free for all scenario!

You would be surprised to know that Nestle's Maggi projecting itself as a Healthy Snack, is banned in various developed countries including the UK. In fact, they have even been fined Nestle for such stuff.

Alas, Large companies of even the size of Nestle, continue to discriminate and have double standards in their marketing policies.

Sad there isnt any active regulation correcting such stuff in India, trying to curb such malpractices by giant organizations with ironically huge "Corporate Social Responsibility" Budgets!

Can we do something?

The picture to your left is sure to inspire a variety of ‘aww’s’ and ‘choo chweet’s’ from you! But did you know that ear muffs, apart from boosting the already high levels of ‘cute’ which all babies come naturally endowed with, also protects their sensitive hearing.

During the first few years of the child’s life, their sense of hearing is quite sensitive and loud sounds can damage their delicate ear drums! According to the National Institute of Occupational Safety and Health, USA, more than 15 minutes of exposure to loud sounds of up to 100 decibels is unsafe; airplane’s going overhead, loud speakers at functions, shrill whistles of trains arriving at the station, live concerts and full stadiums are just some of the many places in India, where the decibel levels are found to be beyond permissible levels and can cause damage to a child's hearing.

A child’s ear canal is quite small as compared to that of an older child or an adult. This means that a child can perceive the same sound at 20 decibels louder than an adult! Ear muffs lower the sound considerably before it reaches the child’s ears i.e. they act as excellent barriers reducing the sound before it reaches the baby’s sensitive ear drums, which otherwise would lead to long term damage in their hearing. Brain Fligor, director of diagnostic audiology, Children’s Hospital Boston, is of the view that such safeguards are necessary for the ears of today’s children as decibel levels have considerably risen in the past few decades and hearing loss from exposure to loud noises is irreversible!

Audiologist advise the use of ear muffs for young children, as long term hearing loss is cumulative and is neither painful nor does it showcase any symptoms except for gradual loss in hearing. So, the next time you go shopping for your little one remember to look out for a pair of cute ear muffs too!

To know more, read

Just read a story about experienced nurses migrating to developed countries in today's Hindustan Times, and found it very disturbing. I am no Healthcare expert, but common sense says that this definitely has large implications to the quality of Healthcare delivery in India. Nursing is an important and a niche profession in India, which has very few takers across the country (Have you heard of any little girl, saying she wants to become a nurse?) Migration can further mar the already bleak scenario of healthcare delivery in India.

Developed Countries have huge advantages as far as wages, working and living standards are concerned. Somethings that make experienced and talented people stop and stay back is the strong social network, stability or the belief in the India Story. 

The challenge that Hospitals and Healthcare in India face, is similar to a business, which employs freshers and takes them for granted (when they are new and when no one is willing to take them up) and later face a major challenge, when they arent able to retain staff, once they have got the good experience. 

If you have noticed, Nurses or "Sister" as we respectfully call them in our country, are generally emigrants most probably from Kerala. These people with their own sweet proprietory accent (in whichever language they speak to you), have already left their native and social circle for a job, and hence dont have a major social attachment. The language they speak is also different from what their patients speak. So what can really stop experienced nurses other than the attachment they could have with their peers and the organization they can work for?

Dissapointingly, if you read further in the same HT story, it also highlights that there have been 5 Strikes by Nurses in the last 6 months in New Delhi alone, which proves the dismal work conditions.

It seems no one cares for the Sisters of India, anymore. Sad.

Other sad highlights of Healthcare story:

1. India has a very low crisis like ratio of Healthcare Personnel to Population, a meagre 1.87 for every 1000 people. The Standard is 2.5. As per WHO, the risk of AIDS, Malaria, Maternal Deaths, Tubercolosis is multiply higher in countries where the Healthcare Personnel to Population ratio is low.

2. Nurses are so despondent for better living and working conditions in Inda, that they are ready to pay a one time fee of Rs. 50K to Rs. 500K to overseas job consultants, to get a job in a developed country.

Here's web link I could find to the entire article:http://www.hindustantimes.com/News-Feed/newdelhi/Nursing-a-foreign-dream/Article1-514546.aspx

I attended a very interesting conference on Medical Ethics over the weekend where I was invited to give a presentation on the ethical aspects of IVF. My talk was on IVF - the good, the bad and the ugly , and I will be uploading this soon.

What I found very interesting was a talk by one of the organisers, Dr Sunil Pandya. He posed a very provocative question - Are conferences on medical ethics of any use ? He was lamenting the fact that inspite of organising many such conferences , the standard of medical ethics seemed to be going progressively downhill in India. Medicine is perceived to be a money making business rather than a profession ; and doctors are seen to be greedy individuals, out to maximise their income, rather than act as healers.

Is this a sign of the changing times we are living in ? Are we fighting a losing battle ? Can we do anything to improve the situation ? Can ethics be taught ? And are doctors willing to learn ?

Most medical students become doctors because they are idealistic. They want to become healers because they like helping patients and want to help them to get better. Unfortunately, medical college seems to kill their ideals and dreams. They often become cynical and uncaring. There are few good role models they can emulate , and in fact they often end up learning bad habits from their seniors – for example, how to be rude to patients so they can complete their duties and find time to catch up on their sleep.

Things are even worse when they start practice. Sadly, no one encourages a young doctor to be ethical. In fact, there is a lot of pressure on the doctor who has just hung out his shingle to be unethical , because the only way a new doctor seems to be able to get patients today is by providing cuts and kickbacks to the referring family physician. Woe betide the junior doctor who does not toe the line – he is likely to be forced to sit in an empty clinic, twiddling his thumbs ! Please remember that young doctors just starting practice are very vulnerable. They are under a lot of financial pressure, as they have loans to payback and families to feed , so they find it quite easy to justify these payments to their own conscience. They are easily tempted to take shortcuts - after all, everyone does it – so why shouldn’t I ? And I’ll only do it in the beginning – I’ll stop once I am well off. Unfortunately, this is a steep slippery slope and once doctors start going downhill, it’s practically impossible to stop and get off ! In order to pay the cuts, they are forced to accept part of their fees in cash, and then the next easy step is to under-report their income and cheat on their taxes.

The presence of pharmaceutical companies with their billion dollar marketing budgets is another potent force in causing doctors to lose their ideals. These companies are easily

able to seduce doctor s into prescribing their expensive drugs , even when they are not in the patient’s best interests , and it’s hard to resist the temptation. Diagnostic centers and laboratories which provide a “referral fee” just add to the vicious cycle, which means that it’s becoming easier day by day to count the number of ethical doctors on your fingertips.

No one likes being unethical. I believe that most people are upright, and would rather earn an honest living, so they can sleep well at night. Most doctors who are well off would rather earn a comfortable income ethically, rather than sell their soul for a few extra rupees. If a doctor has an adequate income, most will refuse to be unethical for an additional measly 20%. However, if he stands to lose over 50% of his income by sticking to his high moral principles , then most doctors, like most ordinary citizens, will crumble. It’s not fair to subject doctors’ morals to such an unfair stress test ! The present system practically forces young doctors to become unethical !

Unfortunately, self-regulation by the medical profession has failed miserably. Similarly, policing by the government is a very ineffective solution, which actually creates even more unethical behaviour, as doctors learn to game the system.

We need to change the ecosystem in which doctors practice. I feel the major reason for the sad state of affairs today is the presence of middlemen between the doctor and patient. This middleman could be the family physician who refers patients to specialists; or the HMO , who decides which doctors are going to be on their panel. If we can cut out the middleman who demands his cut, and ensure that the doctor-patient relationship becomes a simple and direct one, I think doctors will have much more incentive to remain ethical and practice honestly. Under these conditions, I believe most doctors will prefer to practice ethically !

Is this a pipedream ? No ! I’d like to offer a simple practical solution which I feel can help to improve the situation and we are trying out the following experiment, to see if it works . HELP is offering grants to provide free websites for doctors . Millions of patients are already online, looking for good doctors – and we need to ensure that good doctors have an online presence, so it’s easy for patients to find them. We hope these websites will help good doctors to showcase their talent, and will allow them to grow their practice ethically. This will help patients as well , who will become aware of what services ethical doctors provide ,and what medical facilities are available in India.

The transparency which the web imposes will: 

1. help to reduce costs, by promoting competition;
2. encourage honesty from doctors ( it’s easy to tell a lie and make tall claims in the four walls of the clinic, but doctors cannot get away with falsehoods online !) 
3. ensure patients have realistic expectations from their doctor.

These websites will also improve the doctor-patient relationship, by allowing much more open communication between doctor and patient, by cutting out the middleman. Interacting with patients online will also help doctors to become more patient-centric and empathetic. Information Therapy - the right information at the right time for the right person - can be powerful medicine and can help to heal a sick healthcare system ! Ideally, every doctor and clinic should have an online patient education resource center – and it’s becoming extremely easy and inexpensive to make sure that they do. 

Why were most doctors ethical in the "good old days" ? I don’t think they were more principled or had higher moral standards ! I feel this was simply because there used to be only one or two doctors in a community and patients quickly learned through word of mouth, who was good and who was bad. This ensured that doctors treated all their patients well, because they were completely dependent upon their patient’s goodwill. Rude doctors or incompetent doctors were soon booted out because patients refused to go to them !

Why do bad doctors flourish today ? This is primarily because patients are clueless. It’s hard for them to get reliable feedback about a doctor from other patients. They cannot differentiate between a good doctor and a bad one because they have limited medical knowledge. However, once good doctors start educating their patients online, the balance of power will change quickly . Patients will be able to learn about their medical problems and treatment options ; and will be able to quickly screen through multiple doctors online, from the convenience of their homes ,so they can select the one they feel is best for them. Once patients have this knowledge and power, doctors will have to improve their bedside manners, if they want to continue to attract patients !

I feel there is no point in complaining about declining ethical standards or waxing lyrical about the good old days. Good doctors do not need to be taught ethics and bad doctors will never learn ! Will my solution solve all problems ? Sadly, no . There will always be greedy doctors who would rather eat cake , and it is true that many bad doctors will also have their own websites. However, over time, thanks to the negative feedback which expert well-informed empowered patients will provide online about these bad doctors, they will be forced to improve ! Meanwhile, good doctors will flourish, thanks to the positive feedback their patients will provide about them. We hope that once all doctors have an online presence, this will create a win-win situation for patients and doctors, and will allow doctors to practice medicine ethically once again ! 

Dr. Aniruddha Malpani is a renowned IVF Specialist based out of Mumbai, India. He also runs the world's largest free patient library - HELP (http://www.healthlibrary.com). Dr. Malpani is also a Director on Board of a series of healthcare organizations and websites. He can be contacted at info@dr.malpani.com

How would you feel, if you were given the choice between working out just one day in the gym as opposed to working out 7 consecutive days that too with the same result? Awe-struck, right?

Jan Helgerud, of the Norwegian University of Science and Technology, is of the opinion that the intensive work out designed for Olympic level athletes can very well work for each one of us! This technique, known as interval training concentrates on short bursts of intense physical exercise with breaks after every short burst.

In a study done on the benefits of interval training, Scientists found that when compared with traditional exercise, it doubled the individual’s endurance! Strength and speed also were found to be showing remarkable improvement in the territory of 10-15%.

Short bursts in interval training include four 4 minute bouts of hard cycling or sprinting with a 3 minute break after every short burst. Other physically taxing sports such as rowing or swimming should also work, says Jan Helgerud. He adds that interval training is twice as effective as normal work out sessions! To sum it up in an interesting analogy, he says that ‘Think of interval training, as a new pill that works twice as well”!

With studies in recent times, focusing on the effects of strenuous activity on older people and people suffering from health problems, having found that there is no conceivable or serious health risk attached to strenuous activity; interval training just might be the answer to your daily gymming woes!

To know more, click here…

“Go sit in that corner”, is a common line that adults use while admonishing their children. Irrespective of whether you are an adult or child reading this, you are bound to have sat in that proverbial corner atleast a few times. But research now has shown that sitting in corners, chairs, sofa’s… or just sitting for a long period of time, in general can contribute to your weight gain and also make you unhealthy in the process!

Let’s do a little bit of math to understand how sitting is unhealthy. Starting with How many hours does a day have? 24! Good; now, how many hours do we sleep?  Give or take 6-8 hours, right! So that leaves us with around 15 spare hours, out of which we spend a majority of the time sitting in chairs at our workplaces! A conclusion derived from recent studies, have found that those who exercised regularly and were healthy but sat for longer hours had larger waists and high BP along with Blood Sugar complications than their other healthy counterparts.

So what exactly is wrong with sitting? For starters, sitting is one of the most passive activities that we indulge in, unknowingly! For comparisons sake, chewing gum burns more energy than sitting on a chair, so does simply standing in one place and shifting our weight from one leg to another, even fidgeting uses more energy than sitting!

But how does sitting affect our weight? Sitting for longer periods of time without taking a break, causes slow weight gain in the territory of 2-4 kgs per year! A major part of the problem with sitting is that you are physically inactive, this physical inactivity affects the production of the lipoprotein lipase, a molecule that plays a central role in how your body processes fats. This molecule is produced by our muscles along with many tissues from our body. A reduction in this molecule leads to many health problems along with heart diseases! But here’s the shocker, active muscles are known to produce a wide range of substances that control how the body stores and uses sugars and fats and sitting for a long period of time, furthers inactivity in these muscles, increasing our health risks.

Another study on people who sat for longer hours without a break, found that they had larger waistlines as compared to their counterparts who took regular breaks to get up, stretch and walk around! They were even reported to have unhealthy profiles of sugar and fat metabolism as compared to the others.

Moral of the story, the next time you see someone sitting in a chair for a long period of time, offer a polite, “Will you please stand up”.

To read more, click here

Given the growth Health Insurance has shown, coupled with its potential in the evolving socio-economic environment in India, Mediclaim as it is popularly known in India remains the top story with all forms of the press. News/columns/opinions in the media quote consumer forums, government bodies as well as 'experts talking about the various opportunities, challenges that Health Insurance consumers face in India.

What’s also noticeable is that most of the news or stories have their eyes expectedly trained on Consumer Issues like disputed claims settled at the Consumer Forums or the Ombudsman. In fact, whenever, a customer wins a case, the press and consequently all of us beam with joy, happy to hear that rights of a consumer, someone like us, are protected, and that there is a resolve to the supposedly draconian ways of the Insurance Company. 

Most recently the press driven by opinion from experts and activists has demanded stricter/deeper regulation on better regula tion on terms and conditions of Insurance policies and how Health Insurance Companies and TPA manage claims. For instance,  take the Times of India (Business) report under the Consumer Watch Section on 19^th February, which talked about Insurance Companies denying the payment of Service Surcharge, Registration Fees charged by the Hospital [which could go to around 10% of the total bill]. Experts in the story recommended regulation of the terms and conditions of the policy as well as inclusion of these charges as a part of the policy.

While the suggestion for better regulation of the terms and conditions of Insurance policies, as a part of constant evolution/change, is welcome, the experts failed to realize that inclusions for any unfathomable charges won’t come for free, and that collectively Insurance premiums pay for the claims.  In short, such unwise inclusions actually end up increasing the premiums, making it more unaffordable, more than anything else.

The Story missed on targeting the real problem. The problem of understanding what these unexplained charges are?

My interactions with Healthcare professionals in Medimanage have shown that there are gross inefficiencies at the administration and costing level in a Hospital, on account of which direct charges that are levied on to the bill such as, room rent, or doctor fees are not scientifically calculated. The Costing department applies an ad hoc [read inflated] direct margin on all costs to arrive at the price to be billed to the customer.

Moreover, you would be surprised to know that most Hospitals do not have a well managed cost management system which calculates indirect overheads like Electricity, Water etc. to each billable service/item in the Hospital. So for e.g. if you manage to ask an accountant of a Hospital how much is his actual margin [gross and net of overheads] when he bills one pair of gloves to a patient, he will never be able to calculate it. This therefor

e is a weak spot for administration offices in almost every Hospital.

To cover these costs and protect their margins, Hospitals have therefore worked around and started loading additional overall loadings on the overall bill calling them different names like Administration Charges, Registration Charges or Surcharge.

Knowing this you will now realize, that the reason behind Insurance Companies denying payment of such charges is not the validity of the charge or managing claims, but the unscientific and open-ended way of charging this on to the bill.

The most crucial root of the whole problem simply lies in the lack of almost any real regulation on the largest to smallest of hospitals or healthcare providers in India. In fact, after some browsing on the internet and talking to some healthcare experts, I realized there isn’t any regulator or a distinct self regulatory association for Healthcare Provider Industry in India, which defines standardization of billing for a hospital.

Looking at lack of regulation, even the most esteemed hospitals and renowned doctors charge a higher charge and fee, depending on whether you own a Health Insurance or not.

So while the aam consumer is facing deduction in claims and the Insurance Companies continue making major losses, the Hospitals are laughing their way to the bank, with disproportionate and unreasonable charges.

Most would be surprised to know that world-over you pay lower charges in a hospital, if you have Insurance, than when you don’t. This is purely because the Health Insurance Company is able to consolidate business and negotiate better rates for surgeries with a Health Service Provider, than an individual who doesn’t have Insurance.

Remember, since the largest market share of health insurance is still owned by Public Sector Companies, we also end up paying for the losses in some way or the other, through taxes!

What we derive from this particular case is that the solution to this Great Indian Mediclaim Circus lies in giving Hospitals a chance to make a self regulatory body [under guidelines from the government],with a set deadline, and therefore getting the hospitals under phased regulation. If the body fails to shape up the billing practices in the stipulated time, a government formed body be formed to close the matter.

While they are loggerheads in India, The World over Health Insurance has been a partner of the Healthcare providers walking hand in hand, taking the Healthcare Industry to another level.

Missing to hit at the source of the problem, and pushing an already regulated body with huge standardized competition is taking on a bull by its tail.

Let’s catch the problem by its root, rather than killing the gardener.

Views expressed in the article are personal. The organization, does not necessarily agree to them.

“Eat your greens”, “eat your cereals”, “don’t forget to drink milk and eat those eggs, calcium is important after all”, “Oh! You just have to eat those beans, they are an amazing source of proteins!”

No one is spared from these statements, which brings us to the question, “When to eat what?” Sure, everyone is telling us what to eat, but are they telling us when? With everyone emphasizing on eating right, no one bothers with the timings, leaving us thoroughly confused in the process! But how would you feel if someone were to give you a scheduled eating plan? You know the one which explains ‘when to eat what” Great right?

A leading daily just did that! With an hour by hour breakdown on what to eat when, there is absolutely no confusion left. Starting with breakfast or the first meal of the day, we are told to consume about 40% proteins, 40% carbohydrates and 20% fats by means of eggs, whole grains and almonds respectively!

This is followed by lunch which advises us to have around 50-60 % carbohydrates, 20-30% proteins and 10-15% fats. This can be done, by means of vegetables-try to include 3 types of vegetables at least, to ensure that you receive the required anti-oxidants or by means of lean chicken, fish or soya for their high protein content. It also advises us to have a dessert with lunch, since we are more likely to digest it well than we would during any other time of the day.

Dinner has to be kept light and consumed at least 3 hours before sleeping. It should be distributed to 40 % protein, 45 % carbohydrate and 15 % fat content. The report tells us that we should opt for dairy products as our protein sources i.e. if we had vegetables during our lunch! Furthermore we are told to include three different vegetables again, if we are to fulfill our body’s fiber and mineral requirements. It discourages eating dessert after dinner, advising a juicy fruit instead for additional fiber content.

Now that we know ‘when to eat what’, we sure are going to try and become healthy and disciplined eaters! To know more, click here…

India’s best known Fashion Designer Rohit Bal suffered from a heart attack on Tuesday morning. He received clot busting drugs from his family physician and was later shifted to Medanta Hospital where ECG and other tests were performed which showed massive damage to his heart muscles. He was supposed to undergo Angiography on Wednesday to examine the damage and to decide whether a bypass or an angioplasty was needed, but he complained of chest pain again at night after which doctors decided to perform emergency angioplasty in which a balloon stent is inserted into the coronary artery to clear the clot and increase the blood flow to the heart.

This article published in WebMD explains the process of Angioplasty and its benefits compared to other methods of treatments,

Why is Angioplasty conducted?

Emergency angioplasty with or without stenting is typically the first choice of treatment for a heart attack.

Although many factors are involved, angioplasty is most often used if you:

• Are having a heart attack.
• Have frequent or severe chest pain ( angina) that is not responding to medicine.
• Have evidence of severely reduced blood flow (ischemia) to an area of heart muscle caused by one or more narrowed coronary arteries.
• Are in good enough health to have the procedure.

It is not an option if,

• There is no evidence of reduced blood flow to the heart muscle.
• Only small areas of the heart are at risk, and you do not have disabling chest pain (angina).
• You are at risk for having complications or dying during angioplasty due to other health problems.
• The affected artery cannot be reached during angioplasty.
• The surgeon or hospital does not have extensive experience in performing these procedures.
• The hospital does not have access to emergency cardiac surgical facilities.

How is it done?

Angioplasty, also know as percutaneous coronary intervention (PCI) or percutaneous transluminal coronary angioplasty (PTCA), is a procedure in which a catheter-guided balloon is used to open a narrowed coronary artery. A stent (a wire-mesh tube that expands to hold the artery open) is usually placed at the narrowed section during angioplasty.

Angioplasty with stent placement has become the first choice of treatment for a heart attack if it can be performed in a timely manner. It is a common procedure in large medical centers.

The goal of this revascularization procedure is to increase blood flow to the heart muscle tissue by clearing out both the blood clot and cholesterol from a ruptured plaque that is blocking the blood vessel. Clot-dissolving drugs (thrombolytics) only remove the blood clot. Angioplasty/stenting is less invasive and has a shorter recovery time than bypass surgery, which requires open-heart surgery.

After you are given a sedative, a thin flexible tube (catheter) is inserted through an artery in the groin or arm and carefully guided up the aorta into the blocked coronary artery. Usually, cardiac catheterization and coronary angiography are performed first to identify any blockages by injecting a dye that contains iodine. The dye makes the coronary arteries visible on a digital X-ray screen.

If there is a blockage, the catheter is advanced to the narrowed portion. Then a small balloon at the end of the tube is inflated. The balloon may stay inflated from 20 seconds to 3 minutes, then it is deflated and removed. The pressure from the inflated balloon presses the plaque against the wall of the artery, making more room for blood to flow. See a picture of a balloon angioplasty .

In most cases, a small, expandable wire-mesh stent is permanently inserted into the artery during angioplasty. The balloon is placed inside the stent and inflated, which opens the stent and pushes it into place against the artery wall to keep the narrowed artery open. Because the stent is like woven mesh, the cells lining the blood vessel grow through and around the stent to help secure it. See a picture of stent placement . This procedure is designed to:

• Open up the artery and press the plaque against its walls, thereby improving blood flow.
• Keep the artery open after the balloon is deflated and removed.
• Seal any tears in the artery wall.
• Prevent the artery wall from collapsing or closing off again (restenosis).
• Prevent small pieces of plaque from breaking off, which might cause a heart attack.

Risks and Benefits

Studies show that angioplasty with stent placement, compared with angioplasty only, reduces the chance that the artery will renarrow and possibly reduces the risk of death. Drug-eluting stents further reduce the chance that the artery will renarrow. But experts do not know yet how safe the drug-eluting stents are over the long term or how well they work over the long term.

Angioplasty does not require open-chest surgery and has less risk for immediate complications. Long-term outcomes of bypass surgery versus angioplasty are similar. But bypass surgery may be a better option for some people, such as those with diabetes.

Bypass surgery may also be better for people who have extensive coronary atherosclerosis. Also, bypass surgery may be the best option when there are blockages in the coronary arteries that cannot be reached during angioplasty or when angioplasty was tried but did not widen the blood vessel enough.

If you smoke, the benefits of angioplasty are much greater if you quit smoking.

To read the entire article, click