Is that angioplasty really necessary?

In the throes of a heart attack, artery-opening angioplasty is a lifesaver. The same can't be said when it's done to open a narrowed heart artery that isn't causing problems.

A quarter of a century ago, Andreas Grüntzig wheeled a colleague with chest pain into a Zurich operating room for a procedure that hadn't been tried before on a human. The Swiss cardiologist guided a balloon-tipped wire into his friend's diseased coronary artery, nestled it in a narrowing that restricted blood flow, and inflated the balloon. Like blasting open a dam, the balloon pushed aside the artery-narrowing plaque and allowed blood to once again flow freely through the artery.

Many cardiologists thought this was a harebrained scheme for restoring blood flow through narrowed or blocked coronary arteries. They were wrong. Today, more than two million people (600,000 of them Americans) undergo balloon angioplasty each year. Some angioplasties are done to stop a heart attack, others to relieve severe chest pain. And some aren't absolutely necessary, or necessarily the right thing to do.

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