Multivessel coronary artery disease: current revascularization strategies

Autor: Eugenia Nikolsky, Monther Boulos, Rafael Beyar, E. Grenadier, Chandrashekhar V. Patil
Rok vydání: 2001
Předmět:
Zdroj: European Heart Journal. 22:1183-1197
ISSN: 0195-668X
DOI: 10.1053/euhj.2000.2497
Popis: The clinical presentation, extent and severity of coronary artery disease, left ventricular function and associated co-morbid conditions influence the choice of initial management of a patient with coronary artery disease. In 1964, Garrett, Dennis, and DeBakey first used coronary artery bypass grafting (CABG) to treat coronary artery disease. Subsequently, in the 1970s, the indications for coronary revascularization, CABG vs medical therapy, were the major focus of investigation. These data enabled the development of comprehensive guidelines for indications of coronary revascularization. Percutaneous transluminal coronary angioplasty (PTCA) was introduced by Dr Andreas Gruentzig in 1977 as a technique for the treatment of proximal, non-calcified, concentric lesions involving a single coronary artery. With improvements in angioplasty equipment and techniques, the use of PTCA was expanded to more complex lesions and in patients with multivessel disease. In the mid-1980s and 1990s, the focus of investigation shifted toward the preferred method of revascularization — CABG vs PTCA. In recent years, there have been major improvements in both surgical and medical treatments. For instance percutaneous and surgical revascularization, the use of stents, arterial bypass conduits, minimally invasive coronary artery surgery have all progressed. Medical treatment, too, such as adjunctive pharmacotherapy (glycoprotein IIb/IIIa inhibitors) and aggressive lipid lowering have reached optimum levels. The purpose of this review is to discuss the current role of various modes
Databáze: OpenAIRE