| Typical indication | Focal, technically approachable stenosis; poor surgical targets; bridge to surgery | Diffuse multivessel or left-main disease; aneurysm-complex anatomy |
| Main advantages | Less invasive; rapid recovery; preserves future options | Arterial graft patency; comprehensive treatment of complex proximal disease |
| Main limitations | Malapposition risk across ectatic/aneurysmal segments; reintervention; calcification may require RA | Sternotomy; peri-operative risks; growth issues in children |
| Long-term signals | KD RA series: event-free survival ≈ 79% at 10 y; ≈ 39% at 20 y (small samples) [16] | National survey (Japan, 2008–2019): 30-day mortality 0.9%; 10-year survival 94% [11] |
| Practical tip | IVUS/OCT optimization; distal-reference sizing; use PET-MFR for complex physiology | ITA-first strategy; heart-team planning |