People with several clogged heart arteries fared better if they had bypass surgery rather than a less-drastic procedure in which the blood vessels are propped open with tiny mesh cylinders called stents, a study of nearly 60,000 patients found.

Those who underwent surgery were significantly more likely to survive and less likely to need repeat procedures.

The study, reported Thursday in the New England Journal of Medicine, is among the largest to compare ways of treating clogged arteries, which can lead to a heart attack.

“For people for whom there are two alternatives, bypass surgery appears to be superior,” said lead researcher Edward Hannan of the State University of New York at Albany.

However, stents have improved remarkably in recent years. Unlike the plain old metal stents, the new devices are drug-coated, allowing medication to drip into blood vessels to keep them open from squeezing shut after procedures to remove blockages.

Bypass surgery also has improved. It has traditionally been performed by stopping the heart and putting the patient on a heart-lung machine. Now many patients can have so-called beating heart surgery, in which the heart continues pumping during the operation.

So with these improved techniques which is better - bypass or stent? The question still remains.

Reference - New England Journal of Medicine, MSNBC

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