Recent randomized trials comparing angioplasty with bypass surgery for the treatment of coronary disease were reviewed. In selected patients with suitable anatomy for both procedures, immediate and long-term follow-up mortality and myocardial infarction rates were similar between angioplasty and bypass surgery, underlining the safety of coronary angioplasty as an initial revascularization strategy. Patients undergoing angioplasty required more repeat revascularization procedures, a situation that may be improved significantly by the use of stents and other means to decrease restenosis. Bypass surgery was somewhat better in controlling mild to moderate angina pectoris, however, it continued to be more expensive than angioplasty strategy even after the repeat revascularization costs were factored in. The results in clinical subgroups, and the potential causes of worse prognosis in diabetic patients after multivessel angioplasty in some of the studies were also discussed. Finally, the pitfalls in translating these randomized study results to daily clinical practice were discussed, and the impact of large, longitudinal follow-up study results in clinical decision making process was emphasized.
Copyright © 2025 Archives of the Turkish Society of Cardiology