Would you favor PCI or CABG for younger patients with radiation-associated cardiac disease in the absence of any significant valvular abnormalities?

Despite the fact that the common and most serious radiation-induced coronary stenosis (RICS) are ostial lesions of the left main and ostial RCA, we heavily favor PCI when feasible due to fibrotic mediastinal changes causing significant technical challenges during CABG. Restenosis is another challeng...

Fortunately, we face this complex clinical scenario less often today with improved radiation therapy protocols. There are no randomized trials of patients with this entity to inform us about specific choices.

In my practice, PCI is our preferred approach for these patients, often younger, who have ra...