Imagine how painful it is for a thin tube with a camera sent from the groin to inside the heart. Imagine the risks involved; of the catheter rupturing or bruising any of the delicate blood vessels. Now think of a heart patient getting simply a less expensive X-ray done to know his heart. The total bill including hospitalization charges is huge in the invasive angiogram done now. MSNBC reports of the spat between radiologists and cardiologists who perform traditional angiograms. Doctors point out the risk from huge doses of radiation required for this new ’super’ X-ray.
What they do not say is that angiogram fatality is not uncommon. Bacterial invasion may infect the areas of insertion of the catheter while the doses of radiation for a one-time test patient will hardly be causing any cancerous mutation. The real issue here is not angiograms versus super X-rays. It is all about livelihoods and money.
Let us consider some issues involved with this new technique:
a) If this is the procedure of choice for detection of atherosclerosis; hardening of the arteries due to fat deposits, then who stands to gain monetarily? The radiologists. So we must be weary of all possible reports praising this diagnostic procedure. Trials were funded in this case by Toshiba Medical Systems. The main investigator was Dr. Julie Miller of Johns Hopkins University. So Toshiba has much in stake for the research to fail.
b) Private medical insurers have strong links with doctors. Thus their policy-judgments are based on the feedbacks they receive from doctors. Now these insurers are scared that having these X-rays may create a radiation epidemic. Hence they are now reluctant to compensate patients undergoing this procure. But whose is the real voice? It is of the organized medical fraternity’s in fear of losing patients.
c) And we have to be very weary of extra-molecular medical research. Whereas
there are strict FDA guidelines for the introduction of new molecules to the public, here is no such strict measure for technical appliances being used in medicine. So we have to wait before we substitute a painless alternative to cardio-vascular compromised patients. Dr. Michael Lauer of the National Heart, Lung and Blood Institute has recently asked US doctors not use the procedure till its safety is proven once for all.
d) The procedure has some limitations. For example, proper pictures in patients with age-related blood vessels’ calcification become difficult. One has to again go back to traditional surgery. This means double costs. And crucially the new system is not fool-proof. An angiogram reveals the whole picture. No one has to do anything further after an angiogram.
It is better to let this procedure develop. Let further research prove no involved carcinogenicity or the need for another diagnostic procedure after getting this X-ray done. Then we will be truly rid of angiograms.
Via: MSNBC
Image: CCM
