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Stents Slightly Better Than Bypass for Blocked Left Coronary Artery
Date:1/29/2008

the report has yet to pass the peer review required by medical journals, he cautioned. "No one should trust the results until it has passed peer review," Hannan said.

The surgery-versus-stent question is important for the left main coronary artery, because it is not a blood vessel readily amenable to surgery, Hannan explained. Nevertheless, his research found that surgery "is used much more frequently than angioplasty in current practice, at least 10 times more often. So, we had only a small group of angioplasty patients in our study," he said.

Dr. Howard C. Herrmann, the director of the Interventional Cardiology and Cardiac Catheterization Laboratories at the University of Pennsylvania who has done studies on the subject, found a number of weaknesses in the Polish research, including the small number of patients.

One notable weakness is the relatively short follow-up period, Herrmann explained.

"Their survival time is out to about two years," he said. "Something as important as left main disease might not manifest itself for five years."

Accordingly, older studies that established surgery as the recommended treatment for the condition measured survival at five years or longer, Herrmann noted. "The bottom line from my standpoint is that this study shows that left main stenting is feasible," he said. "I don't think it answers the question about whether it is a better strategy than surgery, which is still considered the standard therapy."

Another report in the same issue of the journal questioned the growing use of a valved stent for aortic stenosis, a condition in which narrowing of a valve reduces the flow of blood from the heart to the aorta and onward to the rest of the body.

The study, by French cardiologists, of 35 cases in which a valved stent was implanted for severe aortic stenosis, found consistent misplacement of the device. "Premature failure of implanted valve stents... might be an
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