Percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) are two treatments available to manage coronary artery disease, one performed by working within the blood vessels and the other in an open surgical procedure. PCI and CABG have different risks and benefits, with PCI being less invasive, while CABG tends to reduce the need for additional procedures in the future. When a patient presents with coronary artery disease, the doctor will need to conduct a thorough investigation before she can make a treatment recommendation.
One important difference between PCI and CABG is the approach. In PCI, the doctor works through the blood vessels to insert stents and use other techniques to clear plaques in the vessels associated with coronary artery disease. This procedure can utilize a number of different types of stents, including medicated options to maintain vascular health. It is less invasive than a surgical procedure and can carry fewer risks for the patient.
In a CABG procedure, the surgeon grafts coronary arteries to bypass an area of blockage or vessel weakness. One or more vessels may be involved. The procedure is more invasive and lengthy, but can also be more effective in the long term. After CABG, the patient may not need additional interventions. By contrast, a patient may need procedures in the future after PCI, as the vessels can narrow and block again.
A doctor evaluating the choice between PCI and CABG may consider issues like the patient's general level of health, as this can be an important factor in the decision. Some patients may not do well under anesthesia and the invasive techniques necessary in bypass surgery. They could benefit from PCI to address the immediate problem, and follow-up evaluation to determine whether additional intervention is necessary. PCI and CABG are also in a constant state of evolution, and the doctor may consider whether an expert in one procedure or the other could deliver a better result.
Patients considering PCI and CABG can ask their doctors as many questions as they want to help them reach an informed decision. Patients may want to ask about surgical outcomes, risks, side effects, and recovery time. It can also be helpful to look up ratings on doctors and medical facilities. It may be possible to get better treatment at a different location, and to have an increased chance of a better outcome by seeing a specialist with an excellent record.