[Percutaneous coronary intervention with stent placement versus bypass operation in symptomatic multiple-vessel disease; lessons from an observational study].
In a large observational study comparing percutaneous coronary intervention (PCI) using stent implantation with coronary-artery bypass grafting (CABG), 3-year survival was better after CABG than after PCI with stenting. This was particularly true in patients with triple-vessel disease, and for patients with two-vessel disease with involvement ofthe proximal left anterior descending artery (LAD). Potential explanations for this finding are that with CABG 'future' culprit lesions are bypassed or that CABG allows a more complete revascularization. Based on the results of this study, the CABG procedure is preferable in those patients with symptomatic multiple-vessel disease with involvement of the proximal LAD, especially if they have accompanying reduced left ventricular function or diabetes mellitus.
van der Hoeven
B L
BL
Leids Universitair Medisch Centrum, afd. Hartziekten, CS-P28, Postbus 9600, 2300 RC Leiden.
Schalij
M J
MJ
van der Wall
E E
EE
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000601:surgery* / Q000628:therapy*; D023921:Coronary Stenosis / Q000601:surgery / Q000628:therapy; D006801:Humans; D009204:Myocardial Revascularization / Q000379:methods; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome