The landmark FREEDOM trial made a case for surgery in high-risk diabetes patients who have multivessel disease, but some experts have expressed concern that a strict interpretation of the findings overlooks important considerations when weighing percutaneous coronary intervention or bypass surgery. "The two procedures are clearly different from a patient perspective, particularly with regards to the invasive nature of the two procedures and the increased stroke risk, especially within 30 days," said SCAI fellow Dr. Ajay Kirtane. Rather than make a clear case for one procedure over the other, Kirtane says FREEDOM promoted collaboration. "For the past five years in our practice, if we are presented with a diabetic patient with multivessel disease, interventionalists take the patient off the cath lab table to consult with a surgeon."

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