Percutaneous transluminal coronary angioplastystenting versus coronary artery bypass grafting

The cost of percutaneous transluminal coronary angioplasty is slightly less than that of coronary artery bypass grafting, but this is offset by an increased requirement for further investigation and intervention. Survival data to 5 years is similar for both techniques in patients with two-vessel disease. Coronary artery bypass grafting is more advantageous In patients with diabetes or three-vessel disease,. The mortality for cardiogenic shock is 55 per cent, but recent evidence suggests that more aggressive support, investigation, and intervention (aortic balloon counterpulsation, angioplasty, or coronary artery bypass grafting) is associated with an improved outcome and lower mortality. If there is evidence to support the cause of cardiogenic shock being a single occlusion, such as a proximal left anterior descending occlusion, 'salvage' angioplasty should be considered where facilities permit.

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