Sunday, October 05, 2008

Which is Superior, Angioplasty or Bypass?

I always hear people around me debating about the superiority of angioplasty and coronary artery bypass grafting. Some insisted angioplasty is good because it carries lesser risk than bypass, while others argued that bypass could prevent heart patients from getting a repeat procedure or surgery over a longer period.

Coronary Angioplasty (or angioplasty, in short) is a technique to treat coronary heart disease and angina. It involves opening narrowed or blocked blood vessels known as coronary arteries of the heart.

Angina is chest pain or discomfort that occurs when an area of the heart muscle does not get enough oxygen-rich blood. A person with angina may feel pressure or squeezing in the chest. The pain may also occur in the shoulders, arms, neck, jaw, or back.

While angioplasty is a procedure, coronary artery bypass grafting (in short, bypass) is a type of heart surgery. It is sometimes called CABG ("cabbage"). During the operation, the surgery reroutes, or "bypasses," blood around clogged arteries by using a segment of a healthy blood vessel from another part of the body to improve blood flow and oxygen to the heart.

In October 2007, a new study revealed that bypass is indeed better than angioplasty at relieving chest pain and preventing the need for a repeat procedure. On the other hand, both angioplasty and bypass could provide patients with heart disease who need a procedure or surgery to clear their clogged coronary arteries the similar 10-year survival rates.

1.2 percent of patients undergoing bypass and 0.6 percent of those being treated with angioplasty incurred strokes. Angina was relieved over a 5-year period in 84 percent of bypass patients comparing with 79 percent of the angioplasty group.

Meanwhile, the researchers also found that 43 percent of patients treated with angioplasty and less than 10 percent of patient undergone coronary bypass required repeat procedures after 5 years.

Nevertheless, as noted by the researchers, emergence of new and refined techniques has made such a comparison to “remain a moving target”. In fact, new studies have already begun to investigate how the availability of drug-coated stents used in angioplasty affects the comparative efficacy of these techniques.

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