Functionally driven complete vs incomplete revascularisation in multivessel XXXX --long-term results from a large cohort.

@entity1 @entity296 @entity583 @entity453 @entity65
BACKGROUND: Complete revascularisation (CR) by means of percutaneous coronary intervention (PCI) has been associated with better long-term prognosis than incomplete revascularisation (IR) in several clinical trials. However, in the published studies, the completeness of @entity296 has been judged mainly on an anatomical basis, while including criteria directed at functionally driven IR might lead to different results. AIM: To examine the potential value of functionally driven IR in a large cohort of @entity1 with multivessel @entity453 (MVD) undergoing PCI. METHODS: The study population consisted of 908 @entity1 with MVD undergoing PCI without stenting between 1988 and 1997. Functionally driven IR was defined as dilation of all segments with >70% stenosis, with the exception of arteries supplying an area of previous transmural @entity583 ( @entity583 ) or a small amount of myocardium. Complete revascularisation was defined as successful PCI of all coronary artery lesions with significant narrowing not fulfilling the above criteria. @entity1 were followed for a mean 11 years (range 8-16 years). End-points included: death, @entity583 , re-PCI or coronary artery bypass grafting (CABG). RESULTS: Complete revascularisation was performed in 284 (31.3%) @entity1 . Follow-up was obtained from 873 (96.1%) @entity1 . There was no significant difference in the frequency of all-cause mortality, @entity65 or @entity583 between @entity1 who underwent CR and IR. @entity1 who underwent IR were more likely to require re-PCI and had a trend toward more frequent CABG. CONCLUSIONS: In comparison to CR, a strategy of functionally driven IR by means of PCI without stenting does not increase the rate of major cardiovascular outcomes, but is related to higher frequency of repeat procedures during a long-term follow-up.
