April 1, 2008 (Chicago) -- Angioplasty may be a perfectly good option for
opening up blockages in the major artery that provides most of the blood to the
heart, South Korean researchers say.
They studied people with blockages in the left main coronary artery. It
supplies blood to the left side of the heart muscle, which is the side that
pumps fresh blood to the rest of the body. Current guidelines call for these
patients to undergo bypass surgery.
"We focused on all-cause mortality and found no statistical difference
between [angioplasty] and bypass surgery," says Seung-Jung Park, MD,
director of interventional cardiology at Asan Medical Center in Seoul.
But angioplasty patients who received stents -- tiny wire mesh tubes used to
prop open an artery -- were more likely than bypass patients to have to undergo
procedures to reopen arteries that had reclogged, he says.
Still, the hope is that some patients with seriously blocked arteries may be
able to avoid the more invasive bypass surgery, Park tells WebMD.
Angioplasty vs. Bypass
In angioplasty, a balloon at the end of a long tube is threaded through an
artery in the groin. The doctor shimmies the probe up through the patient's leg
and right into the arteries of the heart. The balloon is inflated at the spot
where the vessel has narrowed, opening it.
To keep the vessel open, doctors often add a stent to the end of the balloon
catheter. Some stents are coated with drugs to further reduce the risk an artery will
In bypass surgery, cardiac surgeons harvest a segment of a healthy blood
vessel from another part of the body and use it to bypass the clogged artery or
arteries, rerouting the blood to improve blood flow to the heart.
For the new study, Park and colleagues analyzed data on 2,240 patients with
left main coronary artery disease treated at 12 medical centers in Korea. Of
these, 318 were treated with angioplasty and bare-metal stents, 784 were
treated with angioplasty and drug-coated stents, and 1,138 underwent bypass
The findings were released at a meeting of the Society for Cardiovascular
Angiography and Interventions being held in conjunction with the American
College of Cardiology. They were simultaneously published online in The New
England Journal of Medicine.