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Editorial
Published at www.nejm.org February 18, 2009 (10.1056/NEJMe0900452)

Coronary Revascularization in Context
Richard A. Lange, M.D., and L. David Hillis, M.D.

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Editor's note: Watch video of a roundtable discussion, participate in a poll, and contribute your comments in our Clinical Directions feature — CABG vs. Stenting: Clinical Implications of the SYNTAX Trial. Commenting closes March 4, 2009.

Coronary-artery bypass grafting (CABG), introduced in 1968, was the only method of coronary revascularization until 1977, when percutaneous balloon angioplasty was first performed. The complications of balloon angioplasty (acute vessel closure in 3 to 5% of patients and restenosis in almost half) prevented its use in patients with severe coronary artery disease. In the 1990s, the introduction of bare-metal stents led to reduced rates of these complications. The improved short-term and long-term procedural success with percutaneous coronary intervention (PCI) allowed for its safe and effective performance in patients with severe coronary artery disease. By the year 2000, more PCI procedures . . . [Full Text of this Article]


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From the Department of Medicine, University of Texas Health Science Center, San Antonio.

This article (10.1056/NEJMe0900452) was published at NEJM.org on February 18, 2009. It will appear in the March 5 issue of the Journal.


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