Stents and coronary artery bypass grafting (CABG) treat blocked arteries and coronary artery disease (CAD).
Stents are a less invasive option, while CABG is a major surgery.
Your healthcare provider will consider how many blockages you have and where they are.
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The best treatment option depends on individual circumstances.
In some situations, the answer is clear.
But, there are also cases in which one option is not distinctly better than the other.
There are risks and benefits to each approach.
Typically, when possible, your wishes will be taken into account along with your healthcare provider’s preferences.
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Stents vs.
When diagnosed with CAD, you need the righttreatment.
Stenting
Anangioplastyinvolves threading a wire to the coronary artery through a small puncture.
The puncture is usually made in the groin or the arm.
This procedure physically widens the diseased blood vessel.
Sometimes a stent is permanently inserted to keep the artery open.
This is a small, tube-shaped gadget.
Stents coated with medication help prevent blood clots and are associated with better survival than regular stents.
Angioplasty is considered minimally invasive.
This means it is done using only small incisions.
Bypass Surgery (CABG)
Coronary artery bypass grafting (CABG)is considered a major surgery.
Your surgeon will get access to your heart through an incision in your chest.
An artery from your leg could be used, for example.
This is called a graft.
Both interventions may cause complications.
That way your treatment plan can be discussed by a whole team of healthcare providers.
In an emergency, it is usually preferred over CABG.
Anacute ST-segment elevation myocardial infarction (STEMI)is the most dangerous kind of heart attack.
If you have this kind of heart attack, an angioplasty can preserve your life.
Another advantage of angioplasty and stenting is that stents come in different sizes, shapes, and materials.
This gives your healthcare provider options when it comes to your treatment.
Angioplasty is minimally invasive, so the recovery is usually easier than it is with CABG.
It is considered a high-risk procedure, however.
Rarely, unexpected complications can occur.
For example, severe bleeding could mean the procedure needs to be rapidly converted to open surgery.
People with diabetes also tend to have better outcomes after CABG surgery than with stenting.
Some situations require CABG.
Angioplasty might not be possible when a blood vessel is extremely frail and diseased, for example.
It may also not be a good choice if the anatomy of the arteries is unusually complicated.
Instead, your healthcare provider may determine that the vessel needs to be replaced.
Typically, CABG is considered to be a more complete treatment.
The Benefits of Revascularization
For non-emergency treatment of CAD, both procedures can help significantly reduce symptoms.
Often, though, they are not better than other kinds of therapy.
Generally speaking, non-emergency revascularization by either method doesn’t improve survival.
It is also difficult to know if it helps reduce the rate of subsequent heart attacks.
However, both stenting and CABG can improve outcomes for patients who are experiencing acute coronary syndrome.
This term describes an emergency heart condition like a heart attack.
Summary
The choice between a stent and CABG will depend on many different factors.
In general, stenting has a shorter recovery time.
Bypass surgery may be better for complicated cases.
Both procedures can help reduce symptoms and have similar outcomes, though.
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2017;58(4):475-480. doi:10.1536/ihj.17-191
