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In this article, Dr Eiswirth and his associates address a hotly debated question in cardiology today: When is percutaneous transluminal coronary angioplasty a suitable alternative to coronary artery bypass surgery in treatment of coronary artery disease? Noting that the lack of prospective trials comparing the two approaches makes this a hard question to answer, the authors look to retrospective studies and experience in collecting evidence on which to base their recommendations.