Stroke Risk Higher after Bypass than Angioplasty: Analysis

By Kathleen Doheny 

The potential for a stroke is far more common after a bypass than after angioplasty, new research reports, even though the risk after either heart procedure is still relatively low.

A team of researchers analyzed the results of 19 clinical trials involving nearly 11,000 patients who were assigned randomly to getcoronary artery bypass graft surgery (CABG) or angioplasty, also called PCA (percutaneous coronary intervention), a procedure in which a balloon is used to re-open the clogged artery.

“At 30 days, stroke was about four times more common with bypass surgery compared to PCA,” said study author Dr. Gregg Stone, a professor of medicine at Columbia University Medical Center in New York City.

Stroke is an important complication to track, Stone noted, adding, “Next to death, it is probably the most feared complication.”

The new analysis is published online Aug. 21 in JACC: Cardiovascular Interventions. It will also be published in the Aug. 28 issue of the Journal of the American College of Cardiology.

In bypass surgery, a healthy artery or vein taken from the patient is grafted, or connected, to other arteries in the heart to bypass the blocked vessel. In angioplasty, a catheter is inserted into the vessel to the point of blockage, and then a balloon is inflated to clear it. Sometimes a stent is used to keep open the vessel.

At 30 days, 1.2 percent of the surgery patients had suffered a stroke, compared with .34 percent of the angioplasty patients. At the one-year mark, 1.83 percent of the surgery patients and .99 percent of the angioplasty patients had had a stroke.

Put another way: “The likelihood of stroke is about 1 in 80 for patients who have surgery and 1 in 300 for patients who have angioplasty,” Stone said.