Urgent CABG is considered in ACS patients with multivessel disease when which condition is met?

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Multiple Choice

Urgent CABG is considered in ACS patients with multivessel disease when which condition is met?

In ACS with multivessel disease, the revascularization plan hinges on whether the coronary anatomy can be effectively treated with PCI. Urgent CABG is considered when the anatomy or pattern of disease is unsuited for PCI—meaning PCI cannot achieve complete or durable revascularization—and the patient has ongoing ischemia or hemodynamic instability. In these situations, rapid and durable revascularization with surgery improves stability and outcomes. If the lesions are suitable for PCI, PCI is typically pursued first; surgery is not the preferred option unless PCI cannot achieve adequate revascularization or the patient remains unstable. Waiting months of medical therapy is not appropriate in this setting, and surgical decisions are not driven by patient preference alone when instability is present.

In ACS with multivessel disease, the revascularization plan hinges on whether the coronary anatomy can be effectively treated with PCI. Urgent CABG is considered when the anatomy or pattern of disease is unsuited for PCI—meaning PCI cannot achieve complete or durable revascularization—and the patient has ongoing ischemia or hemodynamic instability. In these situations, rapid and durable revascularization with surgery improves stability and outcomes. If the lesions are suitable for PCI, PCI is typically pursued first; surgery is not the preferred option unless PCI cannot achieve adequate revascularization or the patient remains unstable. Waiting months of medical therapy is not appropriate in this setting, and surgical decisions are not driven by patient preference alone when instability is present.

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