Multi-vessel coronary disease and percutaneous coronary intervention

he goal of percutaneous coronary intervention (PCI) is to provide a safe, effective, less invasive alternative to coronary artery bypass graft surgery (CABG). When introduced by Andreas Gruentzig 25 years ago, he envisioned the procedure to be a technique that would delay the need for CABG until severe multi-vessel coronary disease was present. Over the years, technological advances in equipment and devices have improved safety as well as short and long term outcomes. This has greatly expanded the indications for the technique and allowed more arteries to be accessible to effective treatment with better patient outcomes. In addition, developments in adjuvant pharmacotherapy have further improved outcomes of percutaneous procedures. The results of many large trials in the 1990s have shown that percutaneous intervention can be equally successful when compared to the ''gold standard'' CABG for patients with multi-vessel coronary artery disease. Now with advances in coronary stent technology, including drug eluting stents, multi-vessel angioplasty is set to make another leap forward with further expansion of the indications and improved outcomes.