Bypass surgery better than angioplasty in long term, study says

MUNICH, Germany (AP) — For heart patients with clogged arteries, the choice between bypass surgery or an angioplasty may come down to one question: How many procedures would you like to have?

In research presented Monday at the European Society of Cardiology meeting in Munich, experts concluded that though bypass surgery and angioplasty offer comparable results, patients who have angioplasties are twice as likely to require another procedure within a year.

“If you don’t want to have another heart operation for at least a decade, you should pick the surgery,” said Dr. Heinz Drexel, professor of medicine at the University of Innsbruck in Austria and spokesman for the European Society of Cardiology. Drexel was not connected to the research.

“But that means you have to have your chest cracked open,” he said.

When arteries become blocked, doctors have two main options.

Traditionally they have done a bypass surgery, which reroutes blood vessels to detour around blockages.

But in recent years, angioplasties have become increasingly popular. An angioplasty is a nonsurgical procedure where a balloon is pushed into a blood vessel to flatten the blockage, leaving a stent to prop the artery open.

In the study results announced Monday, European doctors compared the effectiveness of open-heart surgery versus angioplasty in a trial of more than 3,000 patients in Europe and the United States.

They excluded patients who had acute heart attacks and included those who had single and multiple vessel blockages.

About a third of the patients had medical conditions that required surgery.

The remaining patients were randomly assigned to receive either surgery or an angioplasty.

Patients who got an angioplasty needed an average of nearly five stents.

In patients who had an angioplasty, nearly 14 percent neded another procedure after a year, compared with about 6 percent of surgery patients.