Coronary bypass surgery versus percutaneous coronary intervention: the saga continues

Coronary artery bypass graft surgery and percutaneous coronary intervention are the treatment options in patients with ischemia and multivessel coronary artery disease (CAD). Comparisons of coronary artery bypass graft and percutaneous coronary intervention have provided conflicting information. For years, experts have debated over the optimal treatment for patients with multivessel CAD. Current data indicate that clinical outcomes following invasive revascularization depend on patient characteristics, cardiac function, coronary disease distribution, and/or the number of diseased vessels. Lately, new data on treatment paradigms have enabled tailoring of treatment to fit the patient, with the anatomic SYNTAX score and some additional variables. This new data should be scrutinized to ensure its successful clinical utilization to provide individualized care for patients with CAD. In this article, we address some important coronary revascularization issues. We present and analyze the new information in the context of its clinical relevance, contemporary revascularization measures, and other tools designed to improve the care of patients with multivessel CAD.