Operation oder Angioplastie bei Koronarer Herzerkrankung - eine Zusammenfassung prospektiv randomisierter Untersuchungen

Während bei Patienten mit symptomatischer Koronarer Eingefäßerkrankung die perkutane transluminale Coronarangioplastie/Stent-Implantation das Therapieverfahren der Wahl darstellt, stehen bei Patienten mit behandlungsbedürftiger Koronarer Mehrgefäßerkrankung ohne Hauptstammstenose mit der aortokoronarvenösen Bypassoperation und der PTCA/Stent Implantation prinzipiell zwei Therapieverfahren zur Auswahl. In den letzten Jahren wurden im Rahmen großer, randomisierter Studien die Ergebnisse der katheterinterventionellen und der chirurgischen Myokardrevaskularisation verglichen [Tab. 1] [Tab. 2]. Die wesentlichen Einschlusskriterien, Studienendpunkte, Unterschiede in Bezug auf die Studienprotokolle und Patientencharakteristika sind in den [Tab. 3], [Tab. 4], [Tab. 5] zusammengefasst. Es werden im Folgenden die Ergebnisse und Limitationen der Vergleichsstudien bei koronarer Mehrgefäßerkrankung unter besonderer Berücksichtigung einer Strategie der inkompletten Revaskularisation mittels PTCA zusammengefasst.

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