Combining PCI and CABG: the role of hybrid revascularization

Abstract

Hybrid coronary revascularization combines the benefits of both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in the treatment of multivessel coronary artery disease (CAD) by combining the benefits of the LIMA-to-LAD graft and drug eluting stent (DES) to non-LAD regions. Through this approach, a patient receives the long-term benefit of the LIMA graft and avoids the morbidity of a full sternotomy and saphenous vein grafts. Available data related to outcomes following hybrid revascularization is limited to small studies. In this review we seek to provide an overview of hybrid revascularization in the era of modern drug eluting stent technology, discuss appropriate patient selection, and comment on future trial design. Additionally, we review the recent literature pertaining to the hybrid approach.

Conflict of interest statement

Disclosure No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1

A proposed algorithm for considering revascularization approaches in patients with multivessel CAD. It should be noted that more evidence is needed prior to advocating hybrid therapy as a routine strategy