Hybrid coronary revascularization (defined as the planned combination of LIMA-to-LAD artery grafting and PCI of >1 non-LAD coronary arter- ies) may be reasonable as an alternative to multi- vessel PCI or CABG in an attempt to improve the overall risk benefit ratio of the procedures. (Level of Evidence: C) Hybrid coronary revascularization, defined as the planned combination of LIMA-to-LAD artery grafting and PCI of $1 non-LAD coronary arteries,1123 is intended to combine the advantages of CABG (ie, durability of the LIMA graft) and PCI.1124 Patients with multivessel CAD (eg, LAD and $1 non-LAD stenoses) and an indication for revascularization are potentially eligible for this approach. Hybrid revascular- ization is ideal in subjects in whom technical or anatomic limitations to CABG or PCI alone may be present and for whom minimizing the invasiveness (and therefore the risk of morbidity and mortality) of surgical intervention is pre- ferred1118 (eg, patients with severe preexisting comorbidities, recent MI, a lack of suitable graft conduits, a heavily calcified ascending aorta, or a non-LAD coronary artery unsuitable for bypass but amenable to PCI, and situations in which PCI of Fihn et al Stable Ischemic Heart Disease: Full Text e421 the LAD artery is not feasible because of excessive tortuosity or chronic total occlusions). Hybrid coronary revascularization may be performed in a hybrid suite in one operative setting or as a staged procedure (ie, PCI and CABG performed in 2 different operative suites, separated by hours to 2 days, but typically during the same hospital stay). Because most hospitals lack a hybrid operating room, staged procedures are usually performed. 