Coronary artery bypass surgery (CABG) and percutaneous coronary angioplasty (PTCA) now offer patients with obstructive coronary disease an unprecedented opportunity for safe and timely myocardial revascularization. PTCA remains the therapy of choice for patients with single-vessel disease, discrete lesions in multiple vessels and recurrent symptoms following CABG. Until randomized trials define the relative roles of PTCA and CABG in patients with diffuse multivessel disease, such patients should be managed surgically. Despite advances in PTCA technology, skilled surgical standby remains essential to the safe practice of PTCA.
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