Is angioplasty with stent better than coronary artery bypass graft?
Q: I wanted to know how far is angioplasty with a stent better than coronary artery bypass graft; which would be the better option for patients who have diabetes mellitus and hypertension for 15 years and who have already undergone coronary artery bypass graft about 5 years back? Is there a chance that the stent will restenose after a period of time (six months to a year)? I have also heard of stents which are coated with some special drug so that they restenose after the effect of the drug is over (after a year or so). Kindly answer my questions.
A:The choice of treatment CABG or PTCA with stenting largely depends on the kind of blockages. Short segments of blocks in good sized arteries are well treated with stents. Drug eluting stents appear to have a better longterm result than ordinary bare metal stents. In a patient with previous history of a CABG; PTCA with stenting is always a much more acceptable treatment in most instances if the kind of blocks are suitable. Both CABG and stenting are essentially palliative treatment strategies and control of diabetes, high BP, keeping cholesterol levels very low and regular exercise programmes are the most important measures. A number of drugs, aspirin, statins, ACE inhibitors reduce the future events very significantly. The decision for the better strategy CABG/Stenting, if required, is best left to the treating physician.