Comparison of CABG and Angioplasty

Results of six major randomized clinical trials of multi vessel angioplasty Vs CABG are now available. The main conclusions are:

Patients undergoing inillti vessel angioplasty require more number of revascularisation at five years follow-up (55 per cent for PTCA Vs 8 per cent for CABG).

•  There is significant angina relief in the surgical group at least in the first three years and they are functionally better. However over a five year period, the difference tends to diminish.
• In select group of patients CABG is associated with better survival.
• One of the trials showed significantly better survival for surgery among diabetic patients at five years (81 per cent Vs 66 per cent).

Introduction of new drug eluting stents have reduced re-stenosis and necessity for revascularisation has come down. In multi vessel stenling, the initial cost will be much higher and is one of the factors taken into account when results are compared.