Relapse Prevention in Angioplasty & Bypass

Coronary Angioplasty & Stenting 

 

Angioplasty and stenting are very common methods to treat atherosclerosis (blood vessel narrowing). Although they are a temporary fix, they are relatively noninvasive and simple to execute.

 

Limitations with this type of procedure is that

 

> If the vessel is too small in the patient then it is inoperable

> 40% restenosis relapse (renarrowing after successful angioplasty procedure) 

> Patients repeat procedures every few months to open up narrowed arteries

 

Patients are prescribed Aspirin supplementation medication after angioplasty in order to stop narrowing activity in blood vessels. 

See limitations of Aspirin supplementation and Aspirin alternatives

 

 

Coronary Arterial Bypass

 

Arterial bypass is a invasive surgerical procedure that involves grafting of vessels and "bypassing" the blocked arteries for coronary circulation. Depending on how many vessels are blocked, a patient may "recieve 1-5 bypasses." During this procedure, a heart-lung machine keeps the patient's circulation.

 

Limitations with this type of procedure is that

 

> Very invasive, takes month to recover

> Also temporary, chance for more blocked vessels to form after surgery

 

Patients are prescribed Aspirin supplementation medication after bypass in order to stop narrowing activity in blood vessels.

See limitations of Aspirin supplementation and Aspirin alternatives

Michaels, A. D.. "Angioplasty Versus Bypass Surgery for Coronary Artery Disease." Circulation 106.23 (2002): 187e-190. Print.

 

There have been advances in angioplasty to prevent in-stent retenosis, see bradytherapy or intracoronary radiation

There have been advances in bypass to lessen invasiveness, see minimally invasive direct coronary artery bypass

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