(January 23, 2008 - Insidermedicine) Bypass surgery remains a better bet for patients with multiple clogged coronary arteries than opening and stenting the blockages, even when the stent slowly releases a drug that helps prevent new blockages from developing, according to research published in the New England Journal of Medicine.

Here is some information about stents:

•    Blockages in the arteries that feed the heart can be treated by threading a balloon-tipped tube through the arteries, usually starting in the groin, right up to the location of the clog. The balloon is then inflated to open the blockage. A stent is a small metal tube placed in the artery to keep it from collapsing.

•    Drug-eluting stents are stents that slowly release a drug directly into the bloodstream that helps prevent the artery from becoming clogged again.

•    While drug-eluting stents are very popular devices, it remains unclear which patients are likely to benefit most from them.

Researchers from the State University of New York at Albany collected data on over 17,000 patients who had received either bypass surgery or stenting with a drug-eluting stent for the treatment of several clogged coronary arteries.

Over 18 months of follow-up, patients who received bypass surgery were  20% less likely to die  than those who received a drug-eluting stent. They were also less likely to have a heart attack or to require another procedure to open newly clogged arteries. The benefits of bypass surgery over drug-eluting stents were seen in patients with blockages in two coronary arteries as well as in those with blockages in three coronary arteries.

Today's research demonstrates that even though the technology associated with stents has improved dramatically – even offering stents that slowly release drugs that prevent new blockages -- bypass surgery still produces the best long-term results in patients with multiple clogged arteries.

For Insidermedicine in Depth, I'm Dr. Susan Sharma.