What is complete vs incomplete revascularization?
Complete revascularization entails addressing all blockages including Chronic Total Occlusion (CTOs). In the past complete myocardial revascularization typically required CABG and OHS. More recently with advances in CTO revascularization techniques the same is being achieved without open heart surgery using the stent procedure.
There is data suggesting there maybe survival benefit that accrues from complete revascularization versus incomplete revascularization whether it is achieved non surgically by the coronary stent procedure or by CABG/OHS.
Reference # 8 (TCT-397 10-year outcome after complete versus incomplete revascularization of patients with multivessel coronary artery disease)
Having stated the above, attempts at complete revascularization even by CABG is a complex issue not entirely without its own limitations.
Reference # 9 (Complete myocardial revascularization: Between myth and reality)
Thus it is not unreasonable for an operator to tailor therapy to the particular patient in question and to balance the risk benefit ratio of complete vs incomplete revascularization.
It maybe prudent in certain target populations like older, sicker and less active patients to settle for near complete but functionally adequate revascularization.