Treatment modalities for coronary artery disease include drugs, percutaneous coronary intervention (PCI) and surgical (open-heart) bypass surgery (CABG). For the choice of treatment modality, the first clinical consideration should be the clinical type of the patient, followed by the anatomical features and pathophysiological significance of the coronary lesion. However, the latter often determines the type of presentation of the former. The three clinical types of coronary artery disease are: stable coronary artery disease, non-ST-segment elevation acute coronary syndrome (ACS), and acute ST-segment elevation myocardial infarction (STEMI). The characteristics and significance of coronary lesions are currently determined by coronary angiography (gold standard), supplemented by intravascular ultrasound (IVUS), flow reserve fraction (FFR) testing or optical interferometric tomography (OCT) for further diagnosis. PCI is a treatment method to improve myocardial perfusion by percutaneous puncture of the femoral or radial artery to unblock the narrowed or even occluded coronary artery lumen using cardiac catheterization techniques (balloon and stent). It has been proven to be one of the most effective methods in the treatment of coronary artery disease for many years, and is widely used in the treatment of coronary artery disease because it is less invasive (no incision is required) and has significant efficacy. However, this treatment has its inherent limitations and is not suitable for all types or lesion characteristics of coronary artery disease, so its indications should be strictly grasped. 1 , stable coronary artery disease is generally considered that standardized drug therapy is the preferred or main treatment modality for stable angina pectoris, and PCI is only one of the effective methods to relieve patients’ symptoms, which cannot reduce the incidence of death and MI overall compared with drug therapy and cannot improve the prognosis, and CABG has no advantage in survival rate. Some people even believe that it is not necessary to perform PCI or CABG for this type of patients because they can take medication. However, based on recent evidence-based medicine, PCI still has an advantage over drug therapy for patients who are still symptomatic on the basis of effective drug therapy, and for patients with clear evidence of more extensive myocardial ischemia. Prognosis can be improved with revascularization in patients with the following characteristics: (1) left main stem lesion with >50% diameter stenosis (I A); (2) proximal anterior descending stenosis ≥70% (IA); (3) 2- or 3-branch lesion with LV hypoperfusion (IB); (4) large myocardial ischemia (ischemic area >10% of LV area confirmed by myocardial nuclear, FFR, and other testing methods, IB). (5) Critical stenosis (50-70% diameter stenosis) in the proximal segment of the anterior descending branch (including the opening), especially if the angiogram shows “whitening” or irregularity of the lesion, or if IVUS and OCT show a vulnerable lesion, and if the patient has combined diabetes or cannot take statin lipid-regulating drugs for a long time due to side effects, PCI is recommended. Hemodynamic reconstruction may improve symptoms in the following patients: any stenosis ≥ 70% with angina, where relevant tests (ECG during attack, nuclear exercise myocardiography or FFR, etc.) confirm that the stenosis is symptom-related and optimal pharmacological treatment has failed (I A). In patients with complex lesions, a cardiac team of cardiovascular physicians, cardiac interventional and cardiac surgeons is recommended to evaluate the patient’s clinical and imaging data and jointly develop a myocardial revascularization strategy. The choice is based mainly on the European System for Cardiac Risk Evaluation ( EuroSCORE) and the SYNTAX scoring system: EuroSCORE is used to predict CABG mortality; SYNTAX is used to identify those at high risk after PCI. If a patient with a three-branch lesion with a EuroSCORE score >6 is at high risk, predicting high mortality for CABG, PCI should be chosen if hematologic reconstruction is necessary and the lesion can still be completed with intervention; conversely, if the SYNTAX score is >33 and the EuroSCORE is low risk, CABG should clearly be chosen for such patients. if both are at high risk, then If both are high risk, the choice of whether or not to perform revascularization and the method of revascularization should be made after thorough discussion with the patient and family, weighing the pros and cons and respecting the wishes of the patient and family. It is worth pointing out that patients with coronary artery disease combined with diabetes mellitus have a worse prognosis and a higher restenosis rate than non-diabetic patients, regardless of the type of revascularization therapy they receive. It is still recommended that CABG is appropriate for those with a large ischemic extent (especially for multi-branch lesions), and CABG is recommended over PCI if the patient’s surgical risk score is within acceptable limits (IIa B).