ABSTRACT
Revascularization for coronary artery disease • Practical considerations in the treatment of multivessel disease • Cost-effectiveness and quality of life • The future • Limitations • Conclusion
The management of coronary artery disease has rapidly evolved over the last 30 years. As a result of multiple large, rigorous, scientific trials, percutaneous coronary intervention (PCI) using stents has been shown to afford a similar mortality outcome as coronary artery bypass surgery in multivessel disease, and in selected cases has replaced surgery as the preferred revascularization strategy. Drug-eluting stents have revolutionized PCI, and new devices to treat chronic total occlusions (CTOs) have been developed, resulting in improved recanalization rates, and reduced restenosis rates. This chapter will summarize the extensive literature available on multivessel stenting and provide an evidence-based guide on this commonly encountered, and difficult clinical dilemma. Finally, the future direction of multivessel stenting will be discussed.
