Because most hospitals lack a hybrid operating room, staged procedures are usually performed. With the staged procedure, CABG before PCI is preferred, because this approach allows the interventional cardiologist to 1) verify the patency of the LIMA-to-LAD artery graft before attempting PCI of other vessels and 2) minimize the risk of perioperative bleeding that would occur if CABG were performed after PCI (ie, while the patient is receiving DAPT). Because minimally invasive CABG may be associated with lower graft patency rates compared with CABG performed through a midline sternotomy, it seems prudent to angio- graphically image all grafts performed through a minimally invasive approach to confirm graft patency.221 To date, no RCTs involving hybrid coronary revascular- ization have been published. Over the past 10 years, several small, retrospective series of hybrid revascularization using minimally invasive CABG and PCI have reported low mor- tality rates (0 to 2%) and event-free survival rates of 83% to 92% at 6 to 12 months of follow-up. The few series that have compared the outcomes of hybrid coronary revascularization with standard CABG report similar outcomes at 30 days and 3. PCI Outcomes 3.1. Definitions of PCI Success The success of a PCI procedure is best defined by 3 interrelated components: angiographic findings, procedural events, and clinical outcomes. 3.1.1. Angiographic Success A successful PCI produces sufficient enlargement of the lumen at the target site to improve coronary artery blood flow. A successful balloon angioplasty is defined as the reduction of a minimum stenosis diameter to 50% with a final TIMI flow grade 3 (visually assessed by angiography) without side branch loss, flow-limiting dissection, or angio- graphic thrombus.7 For coronary stents, a minimum stenosis diameter of 20% (as visually assessed by angiography) has previously been the clinical benchmark of an optimal angio- graphic result. 