USMLE Step 2 (Fach) / Cardiology (Lektion)
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PCI vs. CABG
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Percutaneous coronary intervention (PCI):- Consists of both coronary angioplasty with a balloon and stenting.- Should be considered in patients with one-, two-, or three-vessel disease. Even with three-vessel disease, mortality and freedom from MI have been shown to be equivalent between PTCA with stenting and CABG. - Best if used for proximal lesions.- Restenosis is a significant problem (up to 40% within first 6 months).
Coronary artery bypass grafting (CABG):- Main indications: → Three-vessel disease with >70% stenosis in each vessel→ Left main coronary disease with >50% stenosis→ Left ventricular dysfunction
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