Angioplasty, Bypass Results Are Similar But Angioplasty Patients Often Must Undergo Procedure Again

Angioplasty offers about the same quality of life and relief from symptoms after five years as heart bypass surgery, according to the biggest comparison of the artery-unclogging procedures.

But the study in today’s Journal of the American Medical Association also noted that angioplasty patients often must undergo the procedure more than once during those five years because the arteries clog back up.

Dr. George Sopko of the National Heart, Lung and Blood Institute in Bethesda, Md., who headed the research, said it shows the two approaches are both very good.

Other doctors were quick to criticize it, however, saying it did not take into account state-of-the-art refinements in treating clogged arteries and did not fully consider the need for repeat angioplasties.

In bypass operations, surgeons cut open the chest and graft new blood vessels to increase blood flow to the heart. In angioplasty, cardiologists thread a balloon into the heart by way of an incision in the thigh to force open clogged blood vessels.

Dr. Timothy Gardner, chief of cardiothoracic surgery at the University of Pennsylvania, said the study underemphasizes the need for repeat angioplasties on some patients. He noted that just 5 percent of bypass patients need another procedure within five years.

Dr. Sidney Smith, chief of cardiology at the University of North Carolina, said the study may have had different results had it considered new techniques in artery unclogging, such as powerful cholesterol-fighting drugs and the use of stents - expandable metal devices inserted into arteries to prop them open.

The study “looks at the state of the art in the late ‘80s, but the state of the art has changed,” Smith said.

Each year, 550,000 Americans have angioplasty or bypass surgery.