stenting or bypass for Ostial LAD Lesion

Three months ago I had an angiography, it showed a mild ostial lesion (40-50%) and a 90% LAD (distal) lesion. One cardiologist even though he recommend the surgery but he is confident of being able to do the stenting . Another cardiologist says that the high risk of thrombosis will go with you for three or four years in case of the angioplasty so he recommends strongly the surgery. They tell me also about the risk of the left main occlusion in the stenting.
I would like your opinion about that.  

[kenkeith]

There is a third option, and that is medication.  The 40-50% occlusion, under AHA/AAC guidelines, does not require intervental procedures.  There are exceptions.

The COURAGE study (google for more info) a scientific study that had the objective to find if there is any difference in longivity among medication, stent, and by-pass for  heart patients.  The conclusion is there is no difference.

There is a risk (small) with DES (drug eluding stents) for blood clots (thrombus) up to approximately a year or more, but the anti-coangulates (plavix and aspirin) provde good protection against clots.  The DES when compared to the bare metal stent fairs better for fewer restenoses.  

About 4 years ago, I had an MI and at that time I had a 98% RCA occlusion (stented with a DES) that was stented to provide more blood/oxygen to the distal portion of the heart where there appeared to be heart wall movement impairment, a 72% occlusion of the circumflex (unstented) and 100% LAD artery.  The LAD although completely blocked had developed collateral vessels and provides a natural by-pass.  I have been on medication for the last 4 years and do not have any symptoms whatsoever.  Every day has been a good day...not even a head cold.

If medication can prevent angina (chest pain, etc.) and based on the COURAGE study , there is no reason in my opinion to have an interventional procedure that in itself is a risk...especially a by-pass.  There are circumstances that call for intervention such as an acute heart attack, by-pass when a stent is not possible, etc.