Adequacy and Extent of Myocardial Revascularization
The extent of myocardial revascularization, accomplished by either CABG or PCI, is a major determinant of survival among patients with ischemic heart disease. Based on the available evidence, revascularization with either CABG or PCI has similar benefits in terms of survival, but should always be at least functionally complete among stable nondiabetic patients with MVCAD provided a thorough evaluation of clinical condition and of both lesion severity and myocardial viability. Diabetic patients benefit from a complete revascularization, better performed, as of now, with CABG. Conversely, in subjects presenting with ACS, an incomplete revascularization with stent-PCI of the culprit lesion is extremely effective if performed in a timely fashion. More extensive revascularization in acute settings may be cautiously considered, and it is prompted by hemodynamic impairment.
KeywordsPercutaneous Coronary Intervention Coronary Artery Bypass Grafting Fractional Flow Reserve Myocardial Viability Myocardial Revascularization
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