What are ACC guidelines for Myocardial revascularization?
Although appropriate use criteria (AUC) have been issued from time to time, the actual guidelines of the American College of Cardiology (ACC) for myocardial revascularization in stable ischemic heart disease were last published in 2011 with a partial update in 2014.
According to these guidelines, when it comes to Left Main disease and multivessel coronary artery disease CABG is listed as a Class I indication for Myocardial Revascularization while PCI/Stenting is listed as a Class II indication.
However, that was before the popular use of miniature cardiac assist devices that have revolutionized high risk PCI.
Moreover the stents used in the studies these guidelines were based upon were mostly the first generation coronary drug eluting stents; the newer stents have a much improved performance profile.