Surgery to Avoid #3: Angioplasty


The third of 5 operations you don't want to get—and what to do instead.

Every year in the United States, surgeons perform 1.2 million angioplasties, during which a cardiologist uses tiny balloons and implanted wire cages (stents) to unclog arteries. This Roto-Rooter-type approach is less invasive and has a shorter recovery period than bypass, which is open-heart surgery. The problem: A groundbreaking study of more than 2,000 heart patients, just released this year at a cardiology conference and in The New England Journal of Medicine, indicated that a completely nonsurgical method—heart medication—was just as beneficial as angioplasty and stents in keeping arteries open in many patients. The bottom line: Angioplasty did not appear to prevent heart attacks or save lives among nonemergency heart subjects in the study.

What to do instead

Take the right meds. If the study is right, medications may be as strong as steel. “If you have chest pain and are stable, you can take medicines that do the job of angioplasty,” says William Boden, MD, of the University of Buffalo School of Medicine, Buffalo, New York, and an author of the study. Medicines used in the study included aspirin, and blood pressure and cholesterol drugs—and they were taken along with exercise and diet changes.

“If those dont work, then you can have angioplasty,” Boden says. “Now we can unequivocally say that.”

Of course, whats right for you depends on the severity of your atherosclerosis risks (blood pressure, cholesterol, triglycerides) along with any heart-related pain. The onus is also on the patient to treat a docs lifestyle recommendations—diet and exercise guidelines—just as seriously as if they were prescription medicines.