March 23, 1995 in Nation/World

Method In Spokane Depends On Hospital Many Local Doctors Prefer Angioplasty, But Not All Facilities Set Up For It

By The Spokesman-Review

How patients are treated for heart attacks in Spokane may depend on where they’re treated.

Only Sacred Heart and Deaconess medical centers are equipped for primary angioplasties, and doctors there do them frequently, said cardiologist Douglas Wysham.

At Holy Family Hospital in north Spokane, however, heart attack patients usually are treated with clot-dissolving drugs, said emergency room physician Randall DeFelice.

“A lot of it depends on your setting,” he said. “If people come here or Valley (Hospital and Medical Center), none of us have cath labs that are backed up by a surgical crew.

“In my mind,” he added, “it’s just as good if not a little bit better than the angioplasties.”

Doctors usually want to start treatment right away, rather than transfer a patient to one of the downtown hospitals, DeFelice said.

Many cardiologists, however, prefer angioplasties over the drugs, such as TPA, said Pierre P. Leimgruber, a doctor at Spokane Cardiology. “Ninety percent of the time, that’s what we do. We’ve been doing this for 10 years.”

Matters are complicated when a patient is flown to Spokane from out-of-town. Doctors then must decide whether a patient can wait for an angioplasty.

“The Tri-Cities is too far. The best thing to do down there is give them TPA,” said cardiologist David Stagaman.

“If they’re real close to town, like Davenport, fly them in. Do an angioplasty.”

While the debate over angioplasties and clot-busters has been going on for several years, Stagaman said he isn’t surprised by the findings in the Michigan study, which strongly support angioplasties.

“I suspect some cardiologists will switch back to using angioplasties because of this,” he said.

At least one Spokane doctor questioned the study. Researcher Marcus DeWood said its results are far different from those of a study he finished in 1992.

In his study, DeWood said, angioplasties were found to be more effective only in heart attacks on the front side of the heart.

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