The Current State of Coronary Revascularization: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery

Brown, Matthew A.; Klusewitz, Seth; Elefteriades, John A.; Prescher, Lindsey

doi:10.1055/s-0041-1735591

Cited by 3 publications

(5 citation statements)

References 75 publications

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“…in a number of parameters, including survival. At the same time, meta-analyses by Chew et al and Brown et al revealed the advantage of CABG over PCI in patients with multivessel disease and intermediate and high Syntax scores(25,26), and comparable results for individuals with low SS(26). Our study revealed a predominance in the frequency of MACCE in patients with intermediate SS who underwent PCI compared with those who underwent CABG (81 % and 50 %, re-…”

supporting

confidence: 74%

“…For example, in our study, we retrospectively selected patients who underwent CABG or PCI under actual clinical conditions. Meanwhile, in recent meta-analyses (24)(25)(26)28) comprising RCTs in which the investigators compared the outcomes of PCI and CABG, disparate approaches were implemented to determine study endpoints, and a different composition of SS groups would have affected the authors' recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…Of these, 200 patients underwent primary PCI with DES placement (n = 200, 100 patients with an SS ≤ 22; and 100 patients with an SS of 23-32). Two hundred six patients also underwent CABG (n = 206, 100 patients with SS ≤ 22; and 106 patients with an SS of [23][24][25][26][27][28][29][30][31][32].…”

Section: Baseline Characteristicsmentioning

confidence: 99%

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Long-term results of myocardial revascularization in patients with multivessel disease

Madiyeva¹,

Aripov²,

Pya³

et al. 2023

BLL

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BACKGROUND: Choosing the method of revascularization -coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) -remains debatable. METHODS: We selected 406 patients with multivessel disease who underwent PCI with a drug-eluting stent (DES) (n = 200, 100 with a SYNTAX score (SS) ≤ 22 and 100 with a SS 23-32); and CABG (n = 206, 100 with a SS ≤ 22 and 106 with a SS 23-32). The mean follow-up period was 9±1.9 years. The endpoints of the study were as follows: major adverse cardiac and cerebrovascular events (МАССЕ), a repeat revascularization (RR), diminished left ventricular ejection fraction (LVEF), and high SS in dynamics. RESULTS: Patients with an intermediate SS needed RR more often with PCI than after CABG (64 % vs 22.6 %; HR: 3.52; CI: 2.19-5.66; р < 0.001). We found no signifi cant differences for other MACCE between the groups. The decrease in LVEF was greater in the low SS subgroup in operated patients than after PCI (39.5 % vs 27.7 %; HR: 0.57; CI: 0.34-0.98; p = 0.04). The difference between the initial and fi nal SS, was greater after the CABG than after PCI (43.5 % vs 10.9 %; HR: 0.26; CI: 0.14-0.47; р < 0.001). CONCLUSIONS: After 9 ± 1.9 years in intermediate SS group CABG exhibited an advantage over PCI with DES in terms of the MACCE indicators due to a smaller number of RR in the CABG group. The CABG group showed a more signifi cant progression of atherosclerosis, and more heart failure cases (Tab. 2, Fig. 4, Ref. 29).

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supporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Long-term results of myocardial revascularization in patients with multivessel disease

Madiyeva¹,

Aripov²,

Pya³

et al. 2023

BLL

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“…CABG is associated with more durable revascularization and lower rates of repeat revascularization compared to PCI. However, it is also associated with a longer recovery period and, in some cases, higher rates of early stroke [8,27]. The choice between PCI and CABG is influenced by several factors, including the patient's clinical presentation, the anatomical complexity of CAD, and the presence of comorbid conditions.…”

Section: Current Management Of Coronary Stenosismentioning

confidence: 99%

Partial Reversal of Coronary Stenosis with Intravenous Hydrogen and Oxygen Nanobubble Administration: A Case Report

Hernowo,

Pardosi,

Subagjo

et al. 2024

Preprint

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Background. Coronary artery disease (CAD) with extensive stenosis presents significant clinical challenges. This case report details the management and outcomes of a 61-year-old male with a notable history of CAD, initially treated with coronary artery bypass grafting (CABG), followed by an innovative intravenous hydrogen and oxygen nanobubble therapy due to recurrent symptoms.Case Presentation. Mr. BH was diagnosed with significant stenosis in the left anterior descending (LAD) artery and left circumflex (LCx) artery, initially managed by CABG. Recurring symptoms led to the adoption of a novel treatment involving hydrogen and oxygen nanobubbles. Following treatment initiation, Mr. BH experienced substantial improvements in physical capacity and symptomatic relief, with an ability to climb 22 flights of stairs and resolution of previous symptoms such as dyspnea and cough. Despite these improvements, subsequent imaging revealed in-stent restenosis and progression of graft disease.Discussion. The application of hydrogen and oxygen nanobubbles as a therapy in CAD is explored, highlighting potential mechanisms such as reduction of oxidative stress and improvement in endothelial function. This case contrasts the effects of conventional surgical and pharmaceutical interventions with the novel nanobubble therapy, illustrating both the benefits and complexities of managing advanced CAD with innovative treatments.Conclusion. While Mr. BH showed clinical improvement with nanobubble therapy, the development of new severe stenosis and restenosis underscores the need for further research to understand the long-term efficacy and mechanisms of nanobubble therapy in complex CAD cases. This case suggests that while innovative therapies may provide symptomatic relief and functional improvement, they do not obviate the need for ongoing surveillance and possibly further intervention.

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“…It was found that low- and intermediate-category patients have similar long-term outcomes regardless of the revascularization strategy implemented ( 15 , 16 ). In contrast, CABG yields better outcomes for severe cases than PCI ( 17 ). Nevertheless, the SYNTAX scoring system lacks an individualized approach and clinical variables to guide the choice of the revascularization strategy accurately.…”

Section: Introductionmentioning

confidence: 99%

Guidezilla™ guide extension catheter I for transradial coronary intervention

Lei

Liang

Fang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundPercutaneous coronary intervention (PCI) is the preferred treatment method for coronary artery diseases (CAD). This study aimed to evaluate the effectiveness and complications of the Guidezilla™ guide extension catheter I (GGEC I) in transradial coronary intervention (TRI).MethodsThis case series study included patients with CAD who underwent TRI using the GGEC I between August 2016 and January 2019 at the First Affiliated Hospital of Xi’an Jiaotong University.ResultsA total of 221 patients aged 65.1 ± 9.26 years were included. Coronary angiography results indicated that most patients (77.8%) had triple-vessel lesions, including 47.5% with chronic total occlusion (CTO). A total of 237 target lesions were treated, most being type C lesions (95.8%). The most common indication for GGEC I use was heavy calcification (67%), followed by extreme tortuosity (12.2%), extreme tortuosity and heavy calcification (10.9%), distally located lesion (4.5%), picking up the retrograde wire (3.2%), anomalous vessel origin (1.8%), and releasing the burr incarceration (0.4%). The mean operation time was 58 min, and the overall success rate was 94.1%. Four patients received a drug-coated balloon. No significant differences were found in operation time and success rate among the low (<23), intermediate (23–32), and severe (>32) CAD groups based on SYNTAX score stratification (P > 0.05). Two subacute thrombosis cases each were reported perioperatively, during hospitalization, and at the 1-month follow-up.ConclusionThe GGEC I might have advantages for TRI and is unaffected by SYNTAX score stratification.

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The Current State of Coronary Revascularization: Percutaneous Coronary Intervention versus Coronary Artery Bypass Graft Surgery

Cited by 3 publications

References 75 publications

Long-term results of myocardial revascularization in patients with multivessel disease

Long-term results of myocardial revascularization in patients with multivessel disease

Partial Reversal of Coronary Stenosis with Intravenous Hydrogen and Oxygen Nanobubble Administration: A Case Report

Guidezilla™ guide extension catheter I for transradial coronary intervention

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