Comparison of surgical improvement of vascular blood flow with drug therapy in subjects with chronic cardiovascular disease

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Comparison of surgical improvement of vascular blood flow with drug therapy in subjects with chronic cardiovascular disease

In addition to medication, surgical interventions to improve vascular blood flow are another means used to treat chronic cardiovascular disease. Surgeons will either perform heart bypass surgery or insert tubular vascular stents into the narrowed blood vessels. The present report explores the safety, efficacy and cost-benefit ratio of these surgical procedures and also considers ethical, legal, social, and organisational aspects.

A systematic review of the literature including various clinical trials compared the use of tubular vascular stents and/or heart surgery with optimised drug therapy. The cost-benefit ratio of all surgical interventions was lower than that of drug therapy alone. This ratio improved in people suffering from concomitant conditions. Analysis of ethical, social and organisational aspects showed that doctors are required to provide comprehensive information about the potential risks of the various treatments and obtain informed consent from patients prior to surgery. Joint decision-making by doctor and patient helps to overcome problems in this regard.

The report concludes that heart bypass surgery is superior to drug therapy alone. For tubular vascular stents, the benefit was less clear and only demonstrated in the short term.

Dokumente

HTA report (PDF, 5 MB, 15.08.2023)

Stakeholder feedback on the HTA report (PDF, 274 kB, 15.08.2023)

HTA protocol (PDF, 705 kB, 29.07.2022)

Stakeholder feedback on the HTA protocol (PDF, 316 kB, 29.07.2022)

Last modification 15.08.2023

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