Historically, most studies of revascularization have been based on and reported according to angiographic criteria. Most studies have defined a significant stenosis as 70% diameter narrowing; therefore, for revascularization decisions and recommendations in this section, a significant stenosis has been defined as 70% diameter narrowing ( 50% for left main CAD). Physiological criteria, such as an assessment of fractional flow reserve, has been used in deciding when revascularization is indicated. Thus, for recommendations on revascularization in this section, coronary stenoses with fractional flow reserve 0.80 can also be considered As noted, the revascularization recommendations have been formulated to address issues related to 1) improved survival and/or 2) improved symptoms. When one method of revascularization is preferred over the other for improved survival, this consideration, in general, takes precedence over improved symptoms. When discussing options for revascu- larization with the patient, he or she should understand when the procedure is being performed in an attempt to improve symptoms, survival, or both. Although some results from the SYNTAX (Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery) study are best characterized as subgroup analyses and hypothesis generating, SYNTAX nonetheless represents the latest and most comprehensive comparison of contemporary PCI and CABG.301,302 There- Hillis et al 2011 ACCF/AHA CABG Guideline e667 fore, the results of SYNTAX have been considered appro- priately when formulating our revascularization recom- mendations. Although the limitations of using the SYNTAX score for certain revascularization recommenda- tions are recognized, the SYNTAX score is a reasonable surrogate for the extent of CAD and its complexity and serves as important information that should be considered when making revascularization decisions. Recommenda- tions that refer to SYNTAX scores use them as surrogates for the extent and complexity of CAD. 