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Stents versus grafts

23rd March 2007

A cardiac surgeon has argued that many heart patients are not given access to the best treatment for their condition.

Professor David Taggart from the University of Oxford says that many cardiologists favour stenting over bypass surgery to the extent that the procedure now outnumbers surgery by at least four-times.  However, he argues that bypass-surgery can offer a better chance of long term survival for patients with severe heart disease and he is concerned that they are being wrongly offered stenting over grafting. "I'm not saying that there are no patients that are suitable for stents, but in those with most severe disease, bypass grafting is a far more effective option,? he said.

Stents are small tubes which are used to treat arteries that have become narrowed due to fatty deposits.  Bypass surgery (or grafting) involves healthy arteries being re-routed around a blockage.  Many patients with coronary artery disease choose to have stenting as it is a less invasive procedure but Professor Taggart says stents carry an increased risk of angina and re-blockage which can mean the patient has to return for further surgery.

Recent studies comparing the clinical and cost effectiveness of stenting over grafting have fallen slightly in favour of the latter but the British Heart Foundation backs both treatments as effective.  A spokesperson for the charity said, "People should be reassured that doctors will make sure they get the best possible treatment available to them."

 

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