Bypass Surgery or Angioplasty: Which is Most Effective?

If you or a loved one suffers from heart disease, there are a variety of treatment options available. The trouble is, which one is the best? Which is most effective?

New study findings released this fall have found that coronary artery bypass surgery is more effective than coronary angioplasty and stenting in patients with severe heart disease.

The study, a joint European and American effort, compared the surgery benefits after three years of 1,800 patients who had undergone the two procedures. The study researchers found that patients who had undergone angioplasty had a 28 percent higher chance of developing a major cardiovascular event, such as a stroke or heart attack; were 46 percent more likely to need a second procedure to reopen the blocked blood vessels; and had about a 22 percent greater chance of dying due to complications than the bypass patients.

During coronary artery bypass surgery, a section of healthy blood vessel, usually taken from inside the chest wall or the lower leg, is attached above and below the blocked artery, allowing blood to bypass the blocked area and flow to the heart muscle. Coronary angioplasty is a much less invasive procedure in which a tiny balloon is inserted and expanded at the site of the blockage to widen a clogged artery. A small metal coil called a stent is then implanted to help keep the artery open.

 The reason bypass surgery may be more effective than coronary angioplasty is that, because it replaces a much longer section of the affected artery, it can treat both the current and emerging blockages of a blood vessel, whereas angioplasty only treats the existing lesion.

Earlier studies have also shown an advantage of bypass surgery over angioplasty, especially in patients over 65 and in patients suffering from other medical problems, such as diabetes.

Treatment Considerations

If you have coronary artery disease, there are several factors that determine which treatment option is best for you, including:

  • Severity and extent of your coronary artery disease
  • Symptoms, such as chest pain and shortness of breath
  • Overall heart function
  • Other medical problems, such as diabetes, kidney disease, peripheral artery disease, or a prior stroke or heart attack

For patients with severe narrowing of very small blood vessels, neither coronary bypass surgery nor coronary angioplasty might be the right treatment choice. Instead, medication and lifestyle changes might be the best treatment option. Some lifestyle changes include:

  • Quitting smoking
  • Eating a heart-healthy diet to reduce high blood pressure and high cholesterol
  • Increasing physical activity
  • Losing weight

If you have coronary artery disease, talk to your doctor about which treatment option is best for you.


Science Daily