[ESC/EACTS guidelines on myocardial revascularization 2018 : The most important innovations].

Area of Science:

• Cardiology
• Cardiovascular Surgery

Background:

• 2018 guidelines for myocardial revascularization are a joint initiative of the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery.
• Establishing indications for revascularization requires assessing the functional significance of coronary artery stenoses.

Purpose of the Study:

• To outline the criteria for selecting the optimal myocardial revascularization strategy.
• To detail the recommended approaches for percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).

Main Methods:

• Utilizing evidence from non-invasive imaging or intravascular hemodynamic measurements to determine functional relevance of stenoses.
• Assessing individual operative risk, technical feasibility, diabetes mellitus, and coronary artery disease complexity (e.g., SYNTAX score).

Main Results:

• Complete revascularization is crucial for achieving prognostic and symptomatic benefits.
• PCI recommendations include radial artery access and drug-eluting stents.
• CABG recommendations emphasize multiple arterial grafts, including the radial artery for high-grade stenoses.

Conclusions:

• The choice of revascularization strategy (PCI or CABG) must be individualized.
• Functional assessment and comprehensive patient/disease evaluation are paramount for successful outcomes.