If a patient has multivessel disease with diabetes, which intervention is generally favored for durable complete revascularization?

• A. CABG
• B. PCI
• C. Medical therapy only
• D. Observation

Answer: (A)

In diabetics with multivessel disease, durable complete revascularization is best achieved with coronary artery bypass grafting. Diabetes tends to cause diffuse, calcified disease that makes long-lasting patency with stents less reliable. CABG uses grafts to bypass blocked segments, and arterial conduits (like the internal mammary artery to the LAD) stay patent longer, enabling complete revascularization across multiple vessels. This approach reduces the need for repeat procedures and often improves long-term outcomes compared with PCI in this population. Medical therapy alone or mere observation would not achieve complete revascularization.