Multivessel coronary artery disease (MVD) is defined as luminal stenosis of at least 70% in at least two major coronary arteries or in one coronary artery in addition to a 50% or greater stenosis of the left main trunk.
Given that percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) both effectively revascularize the myocardium, there has been ardent study of and debate over the optimal revascularization strategy for patients with MVD.
In some randomized trials comparing revascularization strategies for patients with diabetes, coronary-artery bypass grafting (CABG) has had a better outcome than percutaneous coronary intervention (PCI).
Drug-eluting stents (DES) are vascular prostheses used by interventional cardiologists to reopen and maintain patent coronary arteries narrowed by arteriosclerosis.
The history of interventional cardiology began with balloon angioplasty in 1977. Sigwart et al. introduced the first
CONCLUSIONS
For patients with diabetes and advanced coronary artery disease, CABG was superior to PCI in that it significantly reduced rates of death and myocardial infarction, with a higher rate of stroke. (Funded by the National Heart, Lung, and Blood Institute and others; FREEDOM ClinicalTrials.gov number, NCT00086450.)
- Balloon angioplasty: Some catheters feature tiny, folded balloons on their tips. ...
- Angioplasty with stent: In addition to balloon treatment, we generally place a stent, a tiny mesh tube that we expand and leave behind to keep the artery open.
