In the early 1980s, cardiologists were still arguing as to whether bypass surgery to improve the coronary artery flow was worthwhile. There were doubts about its safety and its long-term benefits. In the early days, many bypasses closed off a few months after the operation, leaving the patients no better off.
These doubts are now dispelled. Bypass surgery is now accepted as improving the quality of life of thousands of angina sufferers, and as saving many lives. It has a very high success rate, and the restenosis rate is diminishing year by year.
To bypass surgery has been added balloon angioplasty and, more recently, laser and stent treatment.
To balloons and bypasses have now been added stents and lasers. The catheter technology that uses balloons can also put stents in place. Stents are tiny tubes, made up of what looks like wire mesh, that can be placed in the narrowed section of artery to keep it open. The stent is placed there in a folded or collapsed form, and springs open when it is released at the right spot. It can be left there permanently, as the lining of the blood vessel grows around the mesh, holding it in place, and at the same time allowing it to remain wide open.
The catheter technology is also being developed to use lasers to burn away plaques that protrude into the bloodstream, under direct vision enabled by fiber optics. This is still a research procedure, but it cannot be long before it becomes one of the choices for the cardiologist.
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