The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Ischemia-guided Revascularization for Stable Ischemic Heart Disease

안정형 협심증 환자에서 허혈에 기반한 치료법

  • Kim, Young-Hak (Division of Cardiology, Department of Internal Medicine, Seoul Asan Medical Center, University of Ulsan College of Medicine)
  • 김영학 (울산대학교 의과대학 서울아산병원 심장내과)
  • Published : 2014.12.01
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Abstract

Current evidence and guidelines support the strategy of ischemia-guided revascularization for treatment of patients with stable coronary symptoms. However, anatomical stenosis is often targeted in revascularization treatment using percutaneous coronary intervention or coronary artery bypass surgery without seriously considering objective evidence of myocardial ischemia. Angiographic complete revascularization was traditionally considered to be an ideal objective of revascularization treatment, particularly for patients with multivessel disease. However, recent observational studies have contradicted the concept of angiographic complete revascularization and have, instead, supported the benefits of ischemia-guided selective revascularization based on noninvasive and invasive functional evaluation for detection of ischemia-producing coronary lesions. No trials have been specifically designed to assess the relative benefits of either strategy. Therefore, the present review explores current concepts of the strengths and weaknesses of anatomical versus functional revascularization.

Keywords

References

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