Evaluation of PTCA versus stenting and bare-metal stenting versus drug-eluting stenting in the treatment of coronary artery disease

Abstract

The risk of developing coronary artery disease (CAD) for both men and women is increasing in society today. Over the past twenty-five years, the concepts of percutaneous transluminal coronary angioplasty (PTCA) and stenting have become dominant modalities in the treatment of CAD. In the late 1970’s and early 1980’s, PTCA was seen as the best possible alternative to bypass surgery until repetitive treatments were required to reopen occluded arteries. Following the failure of PTCA, stenting and derivatives of stenting with drug-eluting compounds have been developed to examine the most effective revascularization technique to reduce the rate of coronary restenosis. Methodology: The purpose of this study was to perform a systematic examination of the literature to evaluate these techniques. Articles used included randomized controlled clinical trials of adults ranging from 50 to 75 years of age who had undergone either PTCA or stenting from the years 1979 to 2006. Key variables evaluated in the study were PTCA, stenting, and drug-eluting stents. Results: Thirty articles met the inclusion criteria and were reviewed using evidence based methods. Following analysis, the overwhelming consensus exists that the use of PTCA with stenting is more effective than angioplasty alone, and drugeluting stenting is more effective than bare-metal stenting in the prevention of re-stenosis in patients with CAD. Conclusion: The most effective treatment for patients with CAD is PTCA with drug-eluting stenting.