Chronic stable angina revascularization guidelines for percutaneous coronary intervention


 * Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

==ACC/AHA Guidelines- Revascularization With PTCA (or Other Catheter-Based Techniques) and CABG (DO NOT EDIT) == {{cquote|

Class I
1. PTCA for patients with two- or three-vessel disease with significant proximal left anterior descending CAD, who have anatomy suitable for catheter-based therapy, normal LV function, and who do not have treated diabetes. (Level of Evidence: B)

2. PTCA or CABG for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD but with a large area of viable myocardium and high-risk criteria on noninvasive testing. (Level of Evidence: B)

3. In patients with prior PTCA, CABG or PTCA for recurrent stenosis associated with a large area of viable myocardium and/or high-risk criteria on noninvasive testing. (Level of Evidence: C)

4. PTCA or CABG for patients who have not been successfully treated by medical therapy and can undergo revascularization with acceptable risk. (Level of Evidence: B)

Class IIa
1. Repeat CABG for patients with multiple saphenous vein graft stenoses, especially when there is significant stenosis of a graft supplying the left anterior descending coronary artery. PTCA may be appropriate for focal saphenous vein graft lesions or multiple stenoses in poor candidates for re-operative surgery. (Level of Evidence: C)

2. PTCA or CABG for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD but with a moderate area of viable myocardium and demonstrable ischemia on noninvasive testing. (Level of Evidence: B)

3. PTCA or CABG for patients with one-vessel disease with significant proximal left anterior descending0 CAD. (Level of Evidence: B)

Class IIb
1. Compared with CABG, PTCA for patients with two- or three-vessel disease with significant proximal left anterior descending CAD who have anatomy suitable for catheter-based therapy and who have treated diabetes or abnormal LV function. (Level of Evidence: B)

2. PTCA for patients with significant left main coronary disease who are not candidates for CABG. (Level of Evidence: C)

3. PTCA for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD who have survived sudden cardiac death or sustained ventricular tachycardia. (Level of Evidence: C)

Class III
1. PTCA or CABG for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD who have mild symptoms that are unlikely due to myocardial ischemia or have not received an adequate trial of medical therapy and
 * a. Have only a small area of viable myocardium or
 * b. Have no demonstrable ischemia on noninvasive testing. (Level of Evidence: C)

2. PTCA or CABG for patients with borderline coronary stenoses (50% to 60% diameter in locations other than the left main) and no demonstrable ischemia on noninvasive testing. (Level of Evidence: C)

3. PTCA or CABG for patients with insignificant coronary stenosis (less than 50% diameter). (Level of Evidence: C)

4. PTCA in patients with significant left main CAD who are candidates for CABG. (Level of Evidence: B)}}

==ESC Guidelines- Revascularization to improve prognosis (DO NOT EDIT) == {{cquote|

Class IIa
1. PCI or CABG for patients with reversible ischaemia on functional testing and evidence of frequent episodes of ischaemia during daily activities. (Level of Evidence: C)}}

==ESC Guidelines- Revascularization to improve symptoms (DO NOT EDIT) == {{cquote|

Class I
1. PCI for one-vessel disease technically suitable for percutaneous revascularization in patients with moderate-to-severe symptoms not controlled by medical therapy, in whom procedural risks do not outweigh potential beneﬁts. (Level of Evidence: A)

2. PCI for multi-vessel disease without high-risk coronary anatomy, technically suitable for percutaneous revascularization in patients with moderate-to-severe symptoms not controlled by medical therapy, in whom procedural risks do not outweigh potential beneﬁts. (Level of Evidence: A)

Class IIa
1. PCI for one-vessel disease technically suitable for percutaneous revascularization in patients with mild-to-moderate symptoms which are nonetheless unacceptable to the patient, in whom procedural risks do not outweigh potential beneﬁts. (Level of Evidence: A)

2. PCI for multi-vessel disease technically suitable for percutaneous revascularization in patients with mild-to-moderate symptoms which are nonetheless unacceptable to the patient, in whom procedural risks do not outweigh potential beneﬁts. (Level of Evidence: A)}}

Vote on and Suggest Revisions to the Current Guidelines

 * The Chronic Stable Angina Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines