Comparing today's revascularization strategies for CAD. Benefits and drawbacks of thrombolytics, PTCA, CABG.

Abstract

A number of factors must be considered when selecting a revascularization strategy for a patient with CAD: Is the patient's condition stable or unstable? How many vessels are affected? What are the benefits and drawbacks of each technique? For patients with an evolving infarction, either thrombolysis or PTCA can achieve early reperfusion. PTCA is also often helpful for those with one- or two-vessel disease; however, restenosis develops in 30% to 50% of patients, usually within 6 months. Although CABG can produce excellent long-term results for patients with three-vessel or left main artery disease and for those with proximal stenosis, the risk of perioperative complications and bypass graft disease remains significant.