Table 1

Considerations for Selecting PCI Versus CABG in Patients With Complex Stable Ischemic Heart Disease

Factors Favoring PCIFactors Favoring CABG
Anatomic complexity for PCI (e.g., chronic total occlusions, heavy calcification, difficult bifurcations)AbsentPresent
Anatomic complexity for CABG (e.g., poor distal runoff)PresentAbsent
SYNTAX scoreLow to midMid to high
CABG risks (e.g., altered mental status, chronic lung disease, porcelain aorta, prior mediastinal radiation)PresentAbsent
Likely complete ischemic revascularization with PCIYesNo
Diabetes, left ventricular function, age, sex, renal insufficiency (independent of anatomic disease complexity and extent)More data needed
High compliance likely with dual antiplatelet agents and follow-upGoodPoor
Patient preferenceMore rapid recovery, lower stroke rateSingle procedure, greater durability
Operator expertiseExpert interventionalistsExpert surgeons

CABG = coronary artery bypass grafting; PCI = percutaneous coronary intervention.