In a 2009 analysis of data from almost 22 000 patients undergoing PCI at a single center, only 90 (0.4%) required CABG within 24 hours of PCI.281 A similarly low rate ( 0.8%) of emer- gency CABG after PCI has been reported by others.284 286 The indications for emergency CABG after PCI include 1) acute (or threatened) vessel closure, 2) coronary arterial dissection, 3) coronary arterial perforation,281 and 4) mal- function of PCI equipment (eg, stent dislodgement, frac- tured guidewire). Subjects most likely to require emer- gency CABG after failed PCI are those with evolving STEMI, cardiogenic shock, 3-vessel CAD, or the presence of a type C coronary arterial lesion (defined as 2 cm in length, an excessively tortuous proximal segment, an extremely angulated segment, a total occlusion 3 months in duration, or a degenerated SVG that appears to be In those in whom emergency CABG for failed PCI is performed, morbidity and mortality rates are increased com- pared with those undergoing elective CABG,287 289 resulting at least in part from the advanced age of many patients now referred for PCI, some of whom have multiple comorbid conditions and complex coronary anatomy. 