Complete versus incomplete coronary revascularization of patients with multivessel coronary artery disease

Abstract

The treatment of patients with multivessel coronary artery disease in need of a revascularization procedure is influenced by the clinical situation (stable vs. unstable), comorbid conditions (diabetes mellitus), and anatomical variables (proximal left anterior artery stenosis, left ventricular dysfunction). Given the invasive nature of coronary artery bypass graft (CABG) operations, surgeons have embraced the concept of complete anatomical revascularization in one procedural stage since the inception of CABG surgery. However, achieving complete coronary revascularization has been more challenging with percutaneous coronary intervention (PCI), and as a result, incomplete procedures are far more common than complete ones. Data continue to emerge on the potential benefits of complete revascularization on clinical outcomes and suggest that complete revascularization should be the goal of therapy whenever possible. The heart team should carefully review the degree to which each revascularization modality can achieve this goal during procedural planning.