Difference between Bypass Surgery and Angioplasty

Key Difference: A Bypass surgery is used for the treatment of narrowed arteries. A detour or a bypass is created around the section of a blocked artery. This new pathway is created by using a graft. An Angioplasty is a procedure in which coronary arteries are unblocked. An angioplasty procedure does not require an open heart surgery.

Arteries may be clogged with fatty material known as ‘plague’. This plague starts assembling in the inner walls of the arteries and the arteries become narrow. A bypass surgery is used for the treatment of narrowed arteries. A detour or a bypass is created around the section of the blocked artery. It is generally related with the coronary artery bypass graft surgery, in which a blood vessel is taken from chest, log or forearm and is grafted to the coronary artery. This new pathway is created by using a graft. A graft used in the process can be either natural or artificial. A natural graft consists of a portion of the veins, whereas an artificial graft can be a man-made synthetic tube that works as vein.

The surgery is most generally performed on the coronary arteries in the heart, the femoral arteries in the groin or the popliteal arteries behind the knee. The graft is attached above and below an obstructed artery. Blood starts streaming though the new graft vessel, and therefore provides the essential oxygen and nutrients. In the process, a detour or bypass for the flow of blood for the arteries is made therefore, the process is termed as a bypass surgery.

Angioplasty is a type of PCI (Percutaneous Coronary Intervention). Angioplasty refers to a non-surgical procedure that is used to open the blocked heart arteries. It is generally performed to treat the patients suffering from cardiovascular diseases. The procedure improves blood flow in the arteries and veins of the body. In the procedure known as balloon angioplasty, imaging techniques are employed to guide a balloon tipped catheter which is a long and thin plastic tube, into the artery or vein. The catheter is then made to reach the vessel which is narrow or blocked. The balloon is inflated so that the vessel opens up. After the successful opening of the vessel, the balloon is deflated and finally removed. The procedure may also involve implantation of a bare-metal or drug-eluting stent to assist in keeping the artery open.

Comparison between Bypass Surgery and Angioplasty:

 

Bypass Surgery

Angioplasty

Definition

A bypass surgery is used for the treatment of narrowed arteries. A detour or a bypass is created around the section of blocked artery.

Angioplasty refers to a non-surgical procedure that is used to open blocked heart arteries. It is generally performed to treat patients suffering from cardiovascular diseases.

 

Used for

Treatment of coronary arteries in the heart, the femoral arteries in the groin or the popliteal arteries behind the knee.

Treatment of stable or unstable angina. Most people who are treated with angioplasty have a partial blockage in one coronary artery.

Type

Surgery

Non-surgical procedure

Risks

Mentioning some of the risks involved in the procedure of Bypass Surgery.

  • Swelling or inflammation at the incision site.
  • blockage of the bypass
  • bleeding from the incision
  • infection

 

Mentioning some of the risks involved in the procedure of angioplasty.

  • Artery Collapsing
  • Bleeding at the catheter insertion site
  • Allergic reation ot contrast dye
  • A blood clot formation inside a stent

 

Potential Candidate for the surgery

  • Possessing symptoms of atherosclerosis (hardening of the arteries), including claudication
  • Have developed diabetic foot, or gangrene (tissue death) in your leg from diabetes or atherosclerosis.
  • Experiencing mesenteric ischemia
  • Possessing leg ulcers
  • Having a pulmonary embolism
  • Have developed a renovascular condition
  • having carotid artery disease

Patients possessing moderate to severe narrowing or blockage in one or more of blood vessels.

Advantages

  • The benefits of a bypass surgery are usually long lasting.
  • It prolongs life in patients with three vessel disease or blockages.
  • Generally results in less need for another procedure in the first year.
  • Can be performed under local anesthesia.
  • Recovery is shorter and less painful compared to surgery.
  • Less expensive than surgery.
  • May be feasible for patients unable to withstand surgery.
  • There is no noticeable scar.

Stay at hospital

Comparatively longer

Comparatively shorter

Disadvantages

  • It is a major procedure
  • It requires a longer recuperation
  • Limited use (can only access a few coronary arteries, best for accessing arteries that supply the left side of the heart), etc.
  • Generally used only for a single or double vessel disease.
  • Is less efficient if there are many points of stenosis in a single artery.
  • May not be effective if plaque is calcified (hardened).
  • Restenosis rate is 25–35 percent with first procedure; may have to be repeated.
  • Cannot be used if ocelusion is located in area not reachable with catheter, etc.

 

Types

  • Femoral-Popliteal Bypass – A healthy graft vessel is taken form elsewhere in the body.
  • Aorta–Bifemoral Bypass – An artificial graft is required for this kind of Bypass surgery.
  • Balloon Angioplasty – It uses a catheter that is passed into an artery. A balloon on the tip of the catheter is expanded into the clogged artery. The balloon is inflated and the artery widens up.
  • Laser Angioplasty - Laser is used in place of balloon. The laser destroys the plague by vaporizing it into gaseous particles.
  • Coronary Atherectomy – Special instruments like tiny rotating blades, diamond tipped drill and combination of a balloon and a shaving blade are used to destroy or cut the plague.
  • Coronary Stenting – It uses stents which are small expandable metal devices. These are left in the place to avoid closing of arteries.

Image Courtesy: en.wikipedia.org, timelymedical.ca

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