Does a hybrid approach to multivessel revascularisation really make sense?

In the current issue, Wrigley and colleagues ask whether a hybrid approach, using a combination of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) using stents, might be the best method of revascularisation in multivessel coronary artery disease (CAD), at least in selected patients1. Their basic premise, that a combination of internal mammary artery grafting (IMA) to the left anterior descending (LAD), with its proven survival benefit at up to two decades of follow-up2,3, combined with newer-generation stents to other coronary territories rather than vein grafts, is an important question that is increasingly debated.