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Updated: Jun 11, 2026

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
05:25

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft

Published on: September 15, 2023

Best way to revascularize patients with main stem and three-vessel lesions. Patients should be operated!

H Reichenspurner1, L Conradi, J Cremer

  • 1Department of Cardiovascular Surgery, University Heart Center Hamburg, University Medical Center Hamburg Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. hcr@uke.de

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|July 10, 2010
PubMed

Insights

Coronary artery bypass grafting (CABG) is superior to percutaneous coronary intervention (PCI) for complex coronary artery disease (CAD). CABG remains the standard of care for patients with three-vessel or left main CAD.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Current clinical practice often favors percutaneous coronary intervention (PCI) for complex coronary artery disease (CAD), diverging from established treatment guidelines.
  • Numerous clinical trials, including observational and randomized studies, consistently demonstrate the superiority of coronary artery bypass grafting (CABG) over PCI.
  • This superiority extends to critical outcomes such as cardiac death and myocardial infarction, as highlighted by landmark trials like SYNTAX.

Purpose of the Study:

  • To evaluate the comparative effectiveness of CABG versus PCI in treating complex coronary artery disease.
  • To reinforce the established guidelines and clinical evidence supporting CABG as the preferred treatment for specific CAD patient groups.

Main Methods:

  • Analysis of evidence from observational and randomized clinical trials.
  • Integration of current treatment guidelines and interdisciplinary expert opinions.
  • Review of landmark studies such as the SYNTAX trial.

Main Results:

  • CABG demonstrates superiority over PCI in treating multivessel and left main coronary artery disease in symptomatic patients.
  • The SYNTAX trial confirmed the advantage of CABG for hard endpoints like cardiac death and myocardial infarction.
  • Appropriateness criteria developed from guidelines and trial data echo the SYNTAX findings.

Conclusions:

  • Coronary artery bypass grafting (CABG) remains the established standard of care for patients with three-vessel or left main coronary artery disease.
  • Despite evolving practices, robust evidence supports CABG over PCI for complex CAD, particularly concerning hard clinical outcomes.
  • Clinical decision-making for complex CAD should align with evidence-based guidelines emphasizing CABG's role.

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