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  • Title: [Percutaneous coronary intervention with stent placement versus bypass operation in symptomatic multiple-vessel disease; lessons from an observational study].
    Author: van der Hoeven BL, Schalij MJ, van der Wall EE.
    Journal: Ned Tijdschr Geneeskd; 2005 Dec 17; 149(51):2837-40. PubMed ID: 16398163.
    Abstract:
    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.
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