Comparison of stenting with minimally invasive bypass surgery for high-grade stenosis of the proximal left anterior descending coronary artery: Six months' follow-up of a randomized study

Abstract

High-grade stenosis of the proximal left anterior descending coronary artery in-patients with single-vessel disease is associated with a significantly worse prognosis and they are considered high-risk group than patients with lesions at any other location. (Varnauskas et al; 1988). Isolated stenosis of the lett anterior descending coronary artery can be treated medically, by percutaneous transluminal coronary angioplasty, or coronary artery bypass grafting. (Mariani et al; 1997) PTCA is more effective in improving symptoms, exercise performance and the quality of life than medical treatment in patients with single vessel coronary artery disease (Parisi et al; 1992). The major disadvantage of angioplasty has been

restenosis requiring repeat interventions with resultant loss of initial cost savings. Compared with the right and the circumflex coronary arteries, the left anterior descending artery (LAD) has been more adversely affected by restenosis (Strauss et al; 1995).

In several studies, the incidence of medium-term adverse events and the proportion of patients requiring repeated revascularization of the target lesion were consistently higher after balloon angioplasty than after conventional coronary-artery bypass grafting in patients with single-vessel (Goy et al; 1999) or multivessel disease (Henderson et al; 1998).