Angioplasty OK for Major Heart Artery
Study Shows Angioplasty May Offer Option to Open Blockages in Heart Artery That Supplies Most of Heart's Blood
Angioplasty vs. Bypass continued...
During three years of follow-up:
- The rates of death, heart attack, and stroke were similar in the two groups.
- Patients treated with bare-metal stents were nearly six times as likely to need a repeat procedure to reopen the affected vessel than those who underwent bypass surgery.
- Patients treated with drug-coated stents were about three times as likely to need a repeat procedure.
The next step is a clinical trial pitting bypass against angioplasty with drug-coated stents in patients with left main artery disease, Park says.
Bypass Still Treatment of Choice
Doctors are enthusiastic about the findings but stress that, for now, bypass surgery remains the treatment of choice for these patients.
"As you push a catheter through to the left main coronary artery, you're temporarily occluding most of the heart's blood supply," says American Heart Association spokesman Vincent Bufalino, MD, of Midwest Heart Specialists in Naperville, Ill. "The risks to the patients are considerable."
In the long term, there is also a risk of artery reclosure, or restenosis, even months or years after angioplasty, Bufalino tells WebMD. "If you're talking about the left main coronary artery suddenly reclosing, that could be a significant problem."
Patrick Serruys, MD, a professor of interventional cardiology at Erasmus University in the Netherlands, says that "many places in the world are now gaining quite acceptable results" using angioplasty in patients with left main coronary artery disease.
"But there's a long way to go before we can change clinical practice."
Cleveland Clinic's E. Murat Tuzcu, MD, moderator of a news conference that discussed the findings, says, "Left main [artery] disease has always been thought of as a surgeon's land. If confirmed in future studies, the implications are tremendous."