Angioplasty Longevity vs Bypass Longevity

Dear CCHC Physicians,
Approximately three years ago(Winter 1997) I had an angioplasty performed on my LAD due to a 95% blockage.  Since then I exercise everyday(a mild 30 minute jog).  My daily medications consist of atenolol, aspirin, imdur, vasotec, hydrodiuril and pravachol.  Total choloesterol is 160 with a LDL of 90 and a HDL of 50.  Homocysteine is aprroxinately 8 and blood pressure is approximatley 115/65 with a resting heart rate of 50.  Each year since the angioplasty I have had a thallium stress test which all indicate normal and similar results.  How long after an angioplasty procedure without any restonis is the procedure considered as reliable as bypass?  Also, I assume I will be on the above regimented lifestyle forever with maybe the exception of the imdur.  Are there any new non-invasive developments that examine blockages other than thallium stress tests or are thallium stress tests as reliable as any other non-invasive test?
Thanks - Jason

[Cleveland Clinic, MD]

Dear Jason,
There are two type of blockages that can occur following a stent placement: The first is called restenosis and is due to a rapid proliferation of scar tissue within the stent and occurs in the first 3-8 months.  The second type is build-up of blockage similar to build-up in other parts of the artery and this takes years.  It's hard to answer your question as to when as stent is considered as reliable as a bypass graft.  There are many factors involved and there is some apple-orange comparisons.  The current feeling is that stenting for single vessel disease is the best treatment although there many be more repeat procedures. Thallium is a very good non-invasive test for your situation.