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Should You Choose a Drug-Eluting Stent Over Coronary Artery Bypass Grafting

What Are the Benefits of Each?

As with most anything, there are pros and cons. This also applies to DESs and CABG. There are many factors that you and your cardiologist will have to consider when determining which procedure is right for you. 
First, let's take a look at some of the benefits of the DES procedure:
  • It's a minimally invasive procedure
  • Lower risk of complications than in CABG
  • Shorter recovery time (usually can go home the next day) than for CABG
  • You can return to work and your normal activities quicker than if you had CABG
  • You don't usually need general anesthesia (although you will likely receive a mild sedative)
  • Major complications are not very common.
Some benefits with CABG:
  • Longer history of successful results and scientific trials
  • Can save your life you are having a heart attack
  • High success rates of relieving chest pain (angina) and shortness of breath. 

What About the Risks?

Although major complications are not too common with stents, there are still some risks to be aware of. Some of these risks include:
  • Infections at the site where the catheter is inserted
  • A lower risk (compared to CABG) of heart attacks, strokes, and sudden cardiac death.
While the use of DESs may be safe and effective for many people, there is also the possibility to develop something called stent thrombosis. This is a blood clot that occurs after the stent is in place. In a small number of people with stents, blood cells can become sticky and clump together to form a small mass (clot). This clot can block the blood flow and may even cause a heart attack or death.
There were some concerns raised in 2006 regarding the risk of blood clots forming on these stents, which lead to a heart attack. However, the U.S. Food and Drug Administration (FDA) has stated that DESs are safe and effective when used appropriately. Your cardiologist will prescribe certain anti-clotting medications (known as dual antiplatelet therapy) that you will take for several months after your procedure to help avoid clotting problems. Make sure you follow your doctor's recommendations carefully and do not stop taking this medication until your doctor tells you to do so. The risk for stent thrombosis is increased in those who stop taking the medications too soon. 
As for CABG, the risk of serious complications is relatively low, but is higher for emergency surgeries. Some of the possible risks of CABG include:
  • Risk of bleeding from site of attached graft
  • Heart rhythm problems
  • Blood clots
  • Infections at the site of the incision
  • Kidney or renal failure
  • Memory loss or difficulty thinking
  • Reactions to anesthesia
  • Death (rare).
Life After a Stent: 5 Realistic Ways to Take Charge of Your Health

Coronary Stent Information

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