Does coronary angioplasty replace, delay, or complement aortocoronary bypass surgery?

Abstract

In single vessel disease angioplasty can replace surgery in the majority of patients. In cases of recurrence at the site of angioplasty or in the case of progression elsewhere, a second intervention can be performed. Thus, in the majority of patients surgery can be replaced; in the minority it can be delayed. In patients with localized multivessel disease consisting of several localized, short stenoses the situation is similar. If coronary atherosclerosis involves long segments of one or more coronary arteries and in patients with vessel occlusions primary surgery is still the first choice of therapy. In some patients angioplasty can complement surgery. After surgery, angioplasty can be carried out in vessels not bypassed or after early bypass occlusion. Stenoses suitable for angioplasty can be treated with lower risk after surgery if collateral providing vessels are bypassed. Angioplasty can also complement surgery if bypass stenosis occurs in aortocoronary venous or in mammary artery bypasses.