In today’s high-tech world of cardiovascular care, the stent has become one of the most frequently used tools in a cardiologist’s arsenal. It’s small, it’s effective, and in many cases, it’s lifesaving. But not every heart blockage requires one, and not every patient benefits in the same way. That’s the message at the heart of Dr. Andrew Rudin’s practice—a seasoned cardiologist who has seen firsthand how critical it is to pause, evaluate, and educate before proceeding with what many assume is a routine fix.
Dr. Rudin has performed and overseen countless procedures in which stents played a vital role in saving lives. He’s quick to affirm their value, especially in emergencies like heart attacks, where restoring blood flow rapidly can prevent irreversible damage. But in his view, the success of stents in acute settings has created a widespread misconception: that any blockage in the arteries demands immediate intervention. That, he warns, can lead to unnecessary procedures, misplaced trust in mechanical solutions, and a neglect of the bigger picture—long-term heart health.
Patients often arrive in his office having already heard those daunting words: “You need a stent.” Sometimes that’s true. But other times, they’ve been offered a one-size-fits-all solution to a nuanced condition. Dr. Rudin believes these conversations deserve more time, more context, and far more empathy. For him, it’s not about how quickly a procedure can be scheduled—it’s about how well the patient understands their diagnosis, their treatment options, and the full spectrum of risks and benefits.
The problem, he explains, stems from a common misunderstanding about what stents actually do. Many patients assume that placing a stent will prevent a heart attack, prolong their life, or cure their heart disease. In reality, the benefits of stenting vary greatly depending on the clinical scenario. In cases of unstable coronary artery disease, such as during or immediately after a heart attack, stents are often essential. They open blocked arteries, restore blood flow, and reduce the risk of further damage. But in cases of stable coronary disease—where the patient is not experiencing acute symptoms—the story is very different.
Years of research have shown that in stable patients, stenting does not reduce the risk of future heart attacks or death any more than medication and lifestyle changes. These findings have been confirmed in major clinical trials, including the COURAGE and ISCHEMIA studies, both of which challenged long-held assumptions about the benefits of elective stenting. Despite this, many patients with stable angina still undergo stent placement, often without a full understanding of the alternatives.
Dr. Rudin sees it as a gap in communication—a space where fear, urgency, and tradition can crowd out clarity. That’s why, when he meets with patients considering a stent, he doesn’t start with the angiogram. He starts with a conversation. He asks about their symptoms, their daily routines, their concerns. He discusses how medications, exercise, and diet might relieve those symptoms or even eliminate them. And then, only if needed, he discusses intervention.
He is particularly concerned about the lasting psychological effect that comes with unnecessary or poorly understood procedures. Patients who undergo elective stenting sometimes leave the hospital believing they are cured, when in fact their underlying disease—atherosclerosis—remains. That false sense of security can delay important lifestyle changes and adherence to medical therapy. In contrast, a well-informed patient who understands the nature of their disease is far more likely to engage in preventive care, make sustainable choices, and reduce future risk.
In his decades of practice, Dr. Rudin has developed a philosophy rooted in education and partnership. He doesn’t dictate; he explains. He wants his patients to ask questions, challenge assumptions, and be active participants in their care. When patients understand that a blockage doesn’t always mean danger, that symptoms can be managed with medication, and that their choices play a significant role in their outcomes, they often feel more empowered and less anxious. And when they do need a stent—when the evidence and their symptoms align—they go into the procedure with confidence, not confusion.
For Dr. Rudin, responsible use of stents is not just about clinical prudence—it’s also about ethical medicine. Every procedure carries risks, even when it’s considered safe. Bleeding, artery damage, allergic reactions, and the need for long-term blood-thinning medications are all factors that deserve discussion. Too often, these risks are minimized or left out of the conversation entirely. He believes patients deserve to understand not only what might go right, but what could go wrong, even if the likelihood is low.
One of the most rewarding aspects of his work, he says, is seeing patients who avoided unnecessary procedures thrive with medical therapy and lifestyle change. These are the success stories that rarely make headlines but define the quiet victories of thoughtful, personalized care. They remind him—and his colleagues—that cardiology is as much about judgment as it is about technology.
As healthcare systems face increasing pressure to manage costs, improve outcomes, and reduce unnecessary interventions, physicians like Dr. Rudin are playing a crucial role. They are challenging outdated models, advocating for evidence-based practice, and reminding both patients and fellow clinicians that more isn’t always better. In a field where doing something can feel more reassuring than doing nothing, it takes experience and confidence to say: let’s wait, let’s talk, let’s think this through.
Looking ahead, Dr. Andrew Rudin remains optimistic. He sees a new generation of cardiologists who are curious, patient-focused, and eager to integrate clinical research into daily practice. He sees patients who are more informed, more engaged, and more willing to be part of the decision-making process. And he sees a future where conversations about heart care include not just procedures and prescriptions, but values, preferences, and goals.
In the end, “Think Before You Stent” is not about discouraging intervention. It’s about restoring balance. It’s about putting the patient—not the procedure—at the center of care. And it’s about honoring the trust that patients place in their physicians with thoughtful, deliberate choices that serve their health, their lives, and their hearts.