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Angioplasty Proves Reasonable Alternative to Bypass Surgery
Date:3/31/2008

But patients who received stents required more procedures to reopen arteries, study found

MONDAY, March 31 (HealthDay News) -- For patients with blockages in the left main coronary artery, percutaneous coronary intervention -- PCI, often referred to as angioplasty -- may be a viable alternative to bypass surgery.

"We focused on all-cause mortality and found no difference between PCI and surgery," Dr. Seung-Jung Park, senior author of the study and director of interventional cardiology at Asan Medical Center in Seoul, South Korea, said at a news conference.

However, the study also found that PCI patients who received stents -- tiny wire-mesh tubes used to prop open an artery -- had much higher rates of revascularization, a procedure needed to reopen arteries that had become clogged again. Bare metal stents had the highest rate of revascularization, the study found.

The findings were presented Monday in Chicago at a meeting of the Society for Cardiovascular Angiography and Interventions, in partnership with the American College of Cardiology, and published simultaneously March 31 in the New England Journal of Medicine.

The left main coronary artery provides most of the blood to the heart's left ventricle. Current guidelines recommend coronary artery bypass grafting (CABG) over percutaneous coronary intervention unless a previous graft has been performed.

And until more studies are conducted, CABG should remain the treatment of choice in these patients, the study authors stressed.

Percutaneous coronary intervention, which refers to a number of procedures used to treat arteries, is usually reserved for patients who aren't good candidates for surgery or who are protected by a previous bypass graft. A typical form of PCI -- angioplasty -- involves inserting a catheter into the artery to widen the vessel, and then hold it open with a stent.

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