Stent vs. Bypass

I recently participated in a study at the University of Wisconsin asking about patient preferences for coronary stents or coronary artery bypass surgery. The question of the study was "given a range of probabilities for death from either procedure and ranges of probabilities for having to repeat the procedure, which one would you choose". Conventional bypass surgery is quite invasive (although newer, minimally invasive procedures exist).

Stents inserted using cardiac catheterization are minimally invasive although there are some risks. Patients are quite often awake, if mildly sedated, during the procedure.

Blocked arteries (indicated with arrows above) are opened and a stent is inserted in each blocked area.

The arteries are then held open by the stent. There are two types of stents, bare metal and coated. Bare metal stents must be used with larger arteries (as pictured above). The coated stents fight accumulation of plaque on the stent (although drugs such as clopidogrel are used to act as an antiplatelet agent).

Since I'm basically very conservative, the chances of death from stent insertion had to be 100% before I would be willing to undergo bypass surgery. What the study questionnaire should have asked is whether one would choose either procedure if neither decreased mortality (as the current studies seem to indicate).

Had they asked the question, I still would have chosen the stent, but...