Indications for Revascularisation

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  • Revascularisation has been one of the primary treatment options for obstructive coronary artery disease (CAD) for decades. Revascularisation of severe left main and multivessel coronary artery disease has been shown to improve survival in both stable ischemic heart disease and acute coronary syndrome.

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    Revascularisation has been one of the primary treatment options for obstructive coronary artery disease (CAD) for decades. Revascularisation of severe left main and multivessel coronary artery disease has been shown to improve survival in both stable ischemic heart disease and acute coronary syndrome.

    Multivessel coronary artery disease (MVCAD) is defined by the presence of ≥50% diameter stenosis of two or more epicardial coronary arteries. The presence of MVCAD indicates poorer prognosis and a significantly higher mortality than single-vessel disease.

    A comprehensive definition of the adequacy of myocardial revascularisation should take into account the size of the vessel, the angiographic and functional severity of the lesion, and the viability of the myocardial territory. Accordingly, anatomic and functional complete revascularisation (CR) are not always synonymous. Generally, the anatomic CR is defined by treatment of all ≥50 % stenosis in vessels of ≥1.5 mm diameter, whereas functional CR is defined by treatment of all lesions assessed as functionally relevant (with both invasive or non-invasive methods) in the presence of myocardial viability in the dependent territory.

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