Over the last several years angioplasty has exceeded coronary bypass surgery as the preferred way to treat coronary artery disease. The stents, narrow tubes inserted into the artery to facilitate blood flow, commonly used in the procedure are less invasive than open-heart surgery and offer greater convenience to the patient and the ability to perform more complex procedures.
However, they are also more likely to lead to restenosis, a recurrence of artery clogging. According to findings in Journal of Cardiac Surgery, newly developed drug-eluting stents (DES) that release a drug directly to the injured blood vessels are less likely to lead to restenosis than traditionally used bare-metal stents (BMS). Controversy exists regarding the role of stents in the treatment of complex multi-vessel coronary artery disease and the potential for late complications.
While studies have found that DES procedures limit restenosis and, consequently, improve quality of life, the associated medical care would cost patients an average of $900 more during the two-year period following the procedure than with BMS. This cost is expected to decrease within five years, however, rendering DES cost-neutral or cost-saving when compared to BMS.
Despite the positive outcomes associated with DES, the procedure should not be viewed as a replacement for surgery. DES have proven to be safe and effective over the short and medium term, but long term effects have not been sufficiently explored.
“The impact of DES has greatly reduced the volume of coronary artery surgeries, however, the two must be regarded as complementary and not competitive strategies,” says Dr. Shahzad G. Raja, author of the study.