This case focuses on the use of cardiac stents vs. coronary artery bypass surgery for severe coronary artery disease by asking the question: Should patients with severe coronary artery disease (three-vessel and/or left main disease) be treated with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)? For patients with three-vessel and/or left main coronary artery disease, CABG reduced rates of major cardiovascular and cerebrovascular events compared with PCI. This difference was largely driven by a reduction in the need for repeat revascularization procedures among patients receiving CABG. Patients who received PCI had a lower rate of stroke, however, which may make PCI an attractive option for some patients. In addition, the authors suggest that patients with less complex coronary artery disease (as assessed using the SYNTAX score) may be particularly good candidates for PCI, but this hypothesis requires further validation.
Successful Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm in a Patient with Severe Coronary Artery Disease Undergoing Off-Pump Coronary Artery Bypass Grafting
