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Coronary revascularization in multivessel disease. Which is better, stents or surgery?

Francis Q Almeda1, R Jeffrey Snell

  • 1Rush Medical College, Rush University, Chicago, IL, USA. falmeda@aol.com

Postgraduate Medicine
|December 31, 2005
PubMed

Insights

This review compares intracoronary stenting (PCI) and coronary artery bypass grafting (CABG) for multivessel coronary artery disease (CAD). It highlights optimal revascularization strategies, especially for diabetic patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Surgery

Background:

  • Coronary artery disease (CAD) is a leading cause of cardiovascular morbidity and mortality.
  • Multivessel CAD necessitates strategic treatment decisions among medical therapy, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).

Purpose of the Study:

  • To review recent comparative data on intracoronary stenting versus CABG for multivessel CAD.
  • To discuss optimal revascularization strategy selection.
  • To provide special consideration for high-risk populations, including diabetic patients.

Main Methods:

  • Literature review of recent data comparing PCI and CABG for multivessel disease.
  • Analysis of therapeutic issues in revascularization strategy selection.
  • Focus on outcomes in specific high-risk patient groups.

Main Results:

  • The review synthesizes current evidence comparing PCI and CABG in multivessel CAD.
  • It identifies key factors influencing the choice between stenting and bypass surgery.
  • Special attention is given to the management of diabetic patients with multivessel CAD.

Conclusions:

  • Optimal revascularization strategy selection is crucial for managing multivessel CAD.
  • Evidence comparing PCI and CABG continues to evolve, impacting clinical practice.
  • Diabetic patients represent a high-risk group requiring careful consideration in treatment planning.

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