The People's Perspective on Medicine

For Blocked Arteries, Is Surgery More Effective Than Stents?

A comparison of stents to CABG results shows that surgery is more effective than stents when people have more than one blocked coronary artery.

Coronary artery bypass grafting, known as CABG for short, is more effective than stents in some cases. Scientists reached this somewhat surprising conclusion by studying the records of over 1,600 heart patients with multiple blocked arteries (The Annals of Thoracic Surgery, May 1, 2019).

When Is Open-Heart Surgery More Effective Than Stents?

For years, stents have been overtaking CABG surgery because placing stents is less invasive. However, a new study shows that for people with multivessel coronary artery disease, CABG results in lower one-year mortality. For patients who had undergone surgery, 7.2 percent died in the subsequent year. That result compares favorably to 11.5 percent of the patients who had undergone stent placement instead.

There were more than 800 patients in each group. In addition, the patients who had undergone bypass surgery were less likely to be readmitted to the hospital than those who had gotten stents.

What Should Heart Patients Do?

The authors recommend a heart team approach to diagnosis and treatment so that patients will get the best advice for their particular cardiac condition. People should realize that if they have problems in multiple coronary arteries, they might benefit more from bypass surgery. It appears to be more effective than stents in such situations.

This is not the first study to cast some doubt on the benefit of stents. Previously, researchers have found that people with stents suffer less from angina but do not survive longer. Above all, stents do not seem to improve heart attack survival rates.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Citations
  • Mulukutla SR et al, "Coronary bypass versus percutaneous revascularization in multivessel coronary artery disease." The Annals of Thoracic Surgery, online May 1, 2019. DOI: https://doi.org/10.1016/j.athoracsur.2019.02.064
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It has long been suspected that angioplasty and stents were not as trouble free or as dependable as a CABG.

For the less adventurous and/or misinformed, the minimally invasive treatment options discussed in this article are preferable to having your sternum sawed in two. It is a gruesome thought and to have this disfigurement and gore avoided at all costs would be the prevailing choice.

The wide open feeling of 3, 4, or 5 new pathways installed in a CABG compares to having a sputtering car engine replaced with a supercharged dynamo. Anything you did before CABG, you can do afterwards, only better.

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