Table 2. Recommendations for revascularization treatment (from the German National Disease Management Guideline "Chronic Coronary Artery Disease" (3).

Coronary artery disease with significant (≥50%) coronary left main stenosis
⇑ ⇑	Surgical revascularization (ACB) should be performed if possible in the case of significant coronary left main stenosis. ACB is superior to PCI and conservative treatment in terms of survival, MACE, and quality of life.
⇑ ⇑	PCI is recommended as an alternative for inoperable patients and patients who refuse surgical revascularization after careful explanation. This holds for the treatment goals "improvement of prognosis" and "quality of life."
Coronary multi-vessel disease with severe proximal stenosis (≥70%)
⇑ ⇑	Revascularization measures should be recommended in patients with multi-vessel disease because the quality of life can be raised and—according to expert opinion and registry data—the prognosis improved.
⇑ ⇑	Complete revascularization should be the goal in multi-vessel disease.
⇑ ⇑	In three-vessel disease (see legend) ACB is the primary and PCI the secondary procedure.
Coronary artery disease with proximal LAD stenosis (>70%)
⇑	Regardless of their symptoms, patients with a proximal LAD stenosis (≥70%) should undergo revascularization.
Coronary single-vessel disease
⇑ ⇑	All other patients (without LAD stenosis) with symptomatic single-vessel disease that cannot be adequately controlled by medical treatment should undergo a revascularization procedure (as a rule PCI) to ameliorate their angina.
Elderly patients (>75 years) with coronary artery disease
⇑ ⇑	Elderly patients (>75 years) with pronounced persisting symptoms despite medical treatment should be recommended revascularization.
⇑ ⇑	In comparison with medical treatment PCI and ACB lead to a clear amelioration of the symptoms of CAD without causing an increase in mortality. They should also be recommended in elderly patients with pronounced persisting symptoms despite medical treatment.

Corresponding to the National Disease Management Guideline "Chronic Coronary Artery Disease," the constellation is termed coronary three-vessel disease when proximal severe stenosis of over 70% is present in three of the great coronary vessels, i.e., both in the left anterior descending artery (LAD) and left circumflex artery (LCX) and in the right coronary artery, or their major branches (LAD: diagonal artery; LCX: left marginal artery).

The recommendations apply to the following clinical situation: diagnosis of chronic CAD with stable angina pectoris/angina equivalent, amenable to revascularization (independent of ventricular function) ⇑ ⇑= strongly recommended; ⇑ = recommended (3) ACB, aortocoronary bypass surgery; MACE, major adverse cardiovascular events; PCI, percutaneous coronary intervention; CAD, coronary artery disease