INDICATIONS AND LIMITATIONS OF CONVENTION AL REVASCULARIZATION PROCEDURES FOR PATIENTS WITH CORONARY-ARTERY DISEASE

The number of cardiologic patients undergoing invasive diagnostic cath eterization is rapidly increasing. Due to more liberal and extensive i ndications for invasive diagnosis patients in relatively unfavorable c linical condition (e.g., elderly patients with severe extra-cardial di sease, patients status post CABG) are being catheterized and, if suita ble and indicated, undergo revascularization procedures. With rapidly increasing procedural skill of cardiovascular surgeons and invasive ca rdiologists even high-risk patients with severe coronary artery diseas e or underlying illness, who were classically excluded from surgical o r catheter-invasive revascularization, are now being treated more agre ssively. The changing indications for diagnostic catheterization and s ignificant changes in the different modes of revascularization- operat ive bypass-surgery or interventional procedures - have led to continuo us changes in the differential indications for these invasive therapeu tic strategies. This article reviews and discusses the currently accep ted indications for surgical and interventional revascularization as w ell as the limitations of these procedures.