title: Can We Improve the Outcomes of Multivessel Disease Using Modified SYNTAX and Residual SYNTAX Scores?
abstract: In spite of the benefits of drug eluting (DES), these advantages were not translated to better outcome when percutaneous coronary interventions (PCI) were compared with coronary artery bypass surgery. PCI strategy allowing stent deployment in all intermediate lesions including small vessels together with DES design may be the reasons of these findings.
  
  
  
  Recently randomized and observational studies demonstrated using functional flow reserve analysis, residual Syntax score risk, or residual ERACI score after PCI that a reasonably incomplete revascularization was associated with good long-term outcome and low events rate at follow-up. In the ERACI IV study, which included patients with multiple vessel disease and left main, all intermediate lesions and severe lesions in small vessels were excluded from the revascularization strategy, and the 3-year follow-up results showed a remarkable low incidence of death/MI and stroke. Intermediate stenosis or severe lesions in small vessels should not be incorporated in the PCI strategy in order to define patient clinical cardiac prognosis or completeness of revascularization.
authors.affiliation: Cardiac Unit, Otamendi Hospital, Buenos Aires School of Medicine, Cardiovascular Research Center (CECI), Callao 1441 4B, C1024AAA, Buenos Aires, Argentina. arodriguez@centroceci.com.ar.
authors.forename: Alfredo E
authors.initials: AE
authors.lastname: Rodriguez
authors.affiliation: Cardiac Unit, Otamendi Hospital, Buenos Aires School of Medicine, Cardiovascular Research Center (CECI), Callao 1441 4B, C1024AAA, Buenos Aires, Argentina.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernandez-Pereira
authors.affiliation: Cardiac Unit, Otamendi Hospital, Buenos Aires School of Medicine, Cardiovascular Research Center (CECI), Callao 1441 4B, C1024AAA, Buenos Aires, Argentina.
authors.forename: Juan
authors.initials: J
authors.lastname: Mieres
authors.affiliation: Cardiac Unit, Otamendi Hospital, Buenos Aires School of Medicine, Cardiovascular Research Center (CECI), Callao 1441 4B, C1024AAA, Buenos Aires, Argentina.
authors.forename: Javier
authors.initials: J
authors.lastname: Mendoza
authors.affiliation: Cardiac Unit, Otamendi Hospital, Buenos Aires School of Medicine, Cardiovascular Research Center (CECI), Callao 1441 4B, C1024AAA, Buenos Aires, Argentina.
authors.forename: Florencia
authors.initials: F
authors.lastname: Sartori
mesh_terms: D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000473:pathology / Q000628:therapy*; D054855:Drug-Eluting Stents; D006801:Humans; D015994:Incidence; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Completeness of revascularization; Coronary artery bypass surgery; Drug eluting stents; Multiple vessels disease; Randomized clinical trials; SYNTAX score; Stent thrombosis