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Rivista sulle Malattie del Cuore e dei Vasi

Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2018 Mar 15

DOI: 10.23736/S0026-4725.18.04654-6


lingua: Inglese

Definitions and clinical impact of revascularization completeness

Cristina AURIGEMMA , Francesco BURZOTTA, Giulio RUSSO, Leonardo PREVI, Carlo TRANI

Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy


The Completeness of Revascularization in patients with multivessel coronary artery disease (CAD) remains an unanswered question. Despite 20 years of investigation there are still major doubts in this topic, reaching as far as to the lack of a standardized definition. The employment of different definition and the multiplicity of confounding variables that in general favor patients who receive a complete revascularization (CR) are the reason of difficult comparisons between studies. The complexity of coronary anatomy diseases and the clinical features play important role in the revascularization strategy. However the clinical impact of CR is different in particular clinical subsets, such as diabetes, ST-segment elevation myocardial infarction, cardiogenic shock, ischemic heart failure. The CR is a desirable objective, but it is not mandatory and sometimes a reasonable incomplete revascularization (IR) offers comparable results. Clinical variables, including patient’s age, life expectancy, the severity of symptoms at presentation, comorbidities (particularly diabetes mellitus), left ventricular function and myocardial viability, as well as coronary anatomy should be consider in the decision making whether to attempt CR or to follow a reasonable IR strategy, for both PCI and CABG, in patients with multivessel CAD.

KEY WORDS: Complete revascularization - Multivessel coronary artery disease - Diabetes - STEMI - Heart failure - Cardiogenic shock

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Publication History

Article first published online: March 15, 2018
Manuscript accepted: March 9, 2018
Manuscript received: February 27, 2018

Per citare questo articolo

Aurigemma C, Burzotta F, Russo G, Previ L, Trani C. Definitions and clinical impact of revascularization completeness. Minerva Cardioangiol 2018 Mar 15. DOI: 10.23736/S0026-4725.18.04654-6

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