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PTCA versus CABG: a different interpretation of the results of randomised trials comparing both treatments
  1. N Danchina,
  2. P Urbanb
  1. aService de Cardiologie, CHU Nancy-Brabois, 54500 Vandoeuvre-lès-Nancy, France, bLa Tour Hospital, 1 Avenue JD Maillard, 1217 Meyrin-Genève, Switzerland
  1. Professor N Danchin, Service de Cardiologie, CHU Nancy, Hôpitaux de Brabois, Rue du Morvan, F- 54511 Vandoeuvre-lès-Nancy CEDEX, France. email: n.danchin{at}

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The choice of the most appropriate mode of myocardial revascularisation remains open in many patients. All randomised trials comparing surgery (CABG) and angioplasty (PTCA) have shown that both modalities are equivalent in terms of survival or infarct free survival; but all showed that patients treated with PTCA required many more admissions for additional revascularisation procedures during follow up. It was suggested that patients be informed at the time of their initial angiography that the PTCA option would mean more subsequent hospitalisations. The need for reintervention can rightly be seen as one of the major limitations of any revascularisation procedure. It is a significant inconvenience for the patient, increases the time away from a normal active life, and is associated with increased costs. In the BARI ((bypass angioplasty revascularization investigation) trial,1 54% of patients randomised to the PTCA arm had …

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