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A study in New York has found surgery is safer than a balloon catheter plus drug-eluting stents for people with more than one blood vessel blocked. There's unwelcome news for cardiologists who pay their Mercedes leases by putting stents into blocked coronary arteries. But it's handy for you and me if we need to make a decision about treatment. The findings are from an 18-month follow-up of almost everyone in New York State who had a non-emergency coronary artery operation or balloon catheter. For those with more than one vessel blocked, coronary artery bypass grafting – surgery – had lower death and repeat procedure rates than the balloon catheter plus the latest stents (which seep drugs into the artery wall to stop re-blocking). This drug-eluting stent study follows similar findings three years ago on bare metal stents versus surgery for multi-vessel disease. For people with single vessel disease the alternative to a stent is medications, and another study has suggested little or no advantage for stents. At the moment the overwhelming majority of people are having stents and if these figures apply to Australia – albeit that not everyone's suited to surgery – there may be five or six preventable deaths a year per thousand people having their arteries unblocked. The trouble is that the people who make the decision about stents versus surgery are the cardiologists – the ones doing the stents and ringing the till.
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