New Study Reveals Comparable Outcomes Between Stents and Bypass Surgery

A recent comprehensive study led by researchers at Stanford Medicine has highlighted significant advancements in the field of cardiovascular interventions, demonstrating that the long-term risks associated with stenting and bypass surgery are now more similar than previously believed. Traditionally, coronary artery bypass grafting (CABG) was regarded as providing superior outcomes, especially concerning durability and reducing the likelihood of repeat procedures. However, the latest findings suggest a shift in this perspective.

The study involved over 1,500 patients with blockages in three major coronary arteries, monitored over a period of five years across 48 medical centers. Participants were randomized to undergo either bypass surgery or stenting, with researchers tracking vital outcomes such as death, stroke, and heart attacks. Interestingly, the data revealed that the risk of death and stroke was virtually identical between the two groups. The incidence of heart attacks was slightly higher in patients who received stents—8.2% compared to 5.3% in the bypass group—yet this difference was minimal. Furthermore, the need for repeat procedures was notably higher among stent patients (15.6%) versus those who had bypass surgery (7.8%), although the repeat stenting was minimally invasive.

Technological and procedural advancements have played a crucial role in this outcome shift. Modern stents are now made from advanced materials, making them more flexible, less inflammatory, and more efficient at delivering drugs that prevent artery re-narrowing. Moreover, the integration of fractional flow reserve (FFR) measurement during procedures—a technique that assesses blood flow in real-time—has significantly improved decision-making, reducing unnecessary stent placements and associated complications.

Dr. William Fearon, the trial’s lead investigator and a professor of cardiovascular medicine, emphasized the importance of these findings. "Overall, the gap in outcomes between stenting and bypass surgery has narrowed dramatically. This represents a major update in how we approach treatment options for coronary artery disease," he explained.

While the results suggest that both procedures are viable with comparable long-term outcomes, individual patient factors remain crucial in decision-making. For example, those with multiple blockages or diabetes may still benefit more from bypass surgery, which can address multiple issues simultaneously. It's essential for patients and physicians to consider the latest evidence to make informed choices about the best intervention.

In summary, this groundbreaking research underscores the importance of technological innovation and personalized treatment strategies in cardiac care, offering new hope for patients requiring revascularization procedures.

Source: https://medicalxpress.com/news/2025-04-stents-bypass-surgery-thought.html