Is the candidate for PTCA always also a candiate for aortocoronary bypass operation?

Abstract

In its early days, PTCA was performed in patients with single-vessel disease, angina pectoris, and a pathologic exercise test, e.g., ST-segment depression, who were also considered for surgery at that time [1]. With increasing experience, skill, and development of the technique, patients with two- and three-vessel disease are now treated with PTCA, and for many of these patients an aortocoronary bypass operation is indicated as well. The question is whether every PTCA candidate should be also a candidate for surgery. In the early days of PTCA the answer was “yes”. As the indications for surgery have become more restrictive in patients with mild angina pectoris, PTCA now is applied more frequently as an alternative to drug therapy rather than as an alternative to surgery.