Bypass Surgery vs. Angioplasty: What’s the Difference?

Angioplasty is a procedure in which a catheter with a balloon on one end is inserted into the blockage site of the artery through a small incision in the groin or arm. This balloon is then inflated to widen the narrowed artery. Often, doctors will insert a stent (a small metal or plastic tube) to prevent the artery from getting blocked again.

During bypass surgery, surgeons take a healthy blood vessel from either inside the patient's chest or from the lower leg. This healthy blood vessel is attached above and below the blocked artery to restore blood flow. As a result, blood flows to the heart through this newly added vessel instead of the blocked part of the blood vessel.

(Read more - Myocardial Ischemia)

The angioplasty procedure does not require doctors to perform any major surgery as it can be done by making a small incision in the leg, arm or wrist. The entire procedure takes about an hour and the wound is small which allows patients to recover quickly. In most cases, general anesthesia is not required before the procedure and the patient can resume normal life within a few days.

On the other hand, bypass surgery is a major surgery that lasts three to six hours. The surgeon makes an eight to ten-inch incision in the chest to reach the heart and perform the surgery. The patient is given general anesthesia to make the entire procedure pain-free. The patient can take up to 12 weeks to recover from bypass surgery, including a day or two in the ICU.

However, both procedures are ineffective in providing a long-term cure for the patient. Angioplasty is shorter-term than bypass surgery because it does not address the underlying cause of the blockage in the artery. A study in India estimated that 15-20% of patients who have undergone angioplasty may be at risk of narrowed arteries again within a few years and may eventually require bypass surgery. In both cases, the patient needs to change his diet and follow a more physically active routine to reduce excess fat or cholesterol.

(Read more - Coronary Angiography)

Doctors choose the surgery for a patient based on his/her condition. They also take into account the severity and progression of the coronary artery disease, symptoms (such as chest pain and shortness of breath), heart function, patient health, patient history, other diseases (such as diabetes or a previous stroke or heart attack) before deciding whether to undergo angioplasty or bypass surgery.

Bypass surgery is usually considered a better option in cases where the patient's arteries are blocked in multiple places or where their left main coronary artery artery is narrowed. However, bypass surgery is not advisable for elderly or frail patients as the procedure can put excessive strain on their bodies.

On the other hand, angioplasty is recommended in cases where the patient does not have much blockage in the arteries and does not suffer from any other disease or health problem. Apart from this, if the patient does not get any benefit from medication and lifestyle changes, then angioplasty is done. Sometimes patients ask for less invasive (small incision) angioplasty to start work soon.

To know whether angioplasty or bypass surgery is right for you, it is important to consult a well-trained cardiologist.

(Read more - Best Diet for Bypass Surgery Patients)

Both bypass surgery and angioplasty are procedures used to remove blockage in the arteries of the heart, but their method is different. In bypass surgery, a path of new blood vessels is created around the blocked or narrow arteries, so that blood flow can be smooth. For this, usually the veins of the chest or leg are used. On the other hand, in angioplasty, the blockage is opened by inserting a balloon in the blocked arteries through a small tube (catheter), and sometimes a stent is also inserted so that the arteries remain open. Bypass surgery is a major surgery and is performed for serious blockages, whereas angioplasty is a less complicated procedure and has a quicker recovery time.