The EXCEL Trial, BBC Newsnight 9th December 2019January 2, 2020
The BBC Newsnight Program, broadcast on Monday 9th December, about the EXCEL clinical trial has, understandably, caused anxiety for some patients and their families. The EXCEL trial compared bypass surgery or stents for the treatment of narrowing of the left main coronary artery – the artery that supplies blood to most of the left side of the heart muscle. The published main result of the trial reported no difference between the two treatment options in these patients but Newsnight has questioned whether this result is correct and whether in fact bypass surgery is a safer treatment.
We believe that both bypass surgery and stents are good treatments for narrowing of the left main coronary artery and that, for each case, their relative merits should be considered in a process of shared decision making that involves the patient and his or her family or friends. In the UK recommendations about the best treatment are made after a detailed discussion between cardiologists, who implant stents, and cardiac surgeons who do bypass surgery. These discussions take place in a multi-disciplinary team meeting or MDT and focus on identifying the best treatment for the individual, taking into account multiple different factors and importantly, the preference of the patient where both options are possible. More information may become available from new analyses of the EXCEL trial but in our view patients and their families should have confidence that, with careful selection, both stents and bypass surgery are safe and effective treatments for narrowing of the left main coronary artery.
Professor Adrian Banning, President of the British Cardiovascular Intervention Society
Mr Richard Page, President of the Society of the Society of Cardiothoracic Surgeons
Professor Simon Ray, President of the British Cardiovascular Society