As any dr in Madhavabaug can tell none are the best option for our patients, but considering a world where we have to choose a lesser evil between these two procedures, I’m sharing conclusion of few Meta Analysis comparing Outcomes of PTCA vs CABG in patients with multiple vessel disease, have also given link below for reference.

At one year, there was no significant difference between the two groups in terms of the rates of death, stroke, or myocardial infarction. Among patients who survived without a stroke or a myocardial infarction, 16.8 percent of those in the stenting group underwent a second revascularization, as compared with 3.5 percent of those in the surgery group. The rate of event-free survival at one year was 73.8 percent among the patients who received stents and 87.8 percent among those who underwent bypass surgery (P<0.001 by the log-rank test). The costs for the initial procedure were $4,212 less for patients assigned to stenting than for those assigned to bypass surgery, but this difference was reduced during follow-up because of the increased need for repeated revascularization; after one year, the net difference in favor of stenting was estimated to be $2,973 per patient.

As measured one year after the procedure, coronary stenting for multivessel disease is less expensive than bypass surgery and offers the same degree of protection against death, stroke, and myocardial infarction. However, stenting is associated with a greater need for repeated revascularization.

https://www.nejm.org/doi/full/10.1056/nejm200104123441502

Compared with CABG, PCI using Stents showed lower 30 days mortality, higher late mortality and lower incidence of stroke. Diabetes and a high SYNTAX were the subgroups that influenced more adversely the results of PCI.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555581/

In patients with multivessel coronary disease, compared with PCI, CABG leads to an unequivocal reduction in long-term mortality and myocardial infarctions and to reductions in repeat revascularizations, regardless of whether patients are diabetic or not. These findings have implications for management of such patients.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1783046

my conclusions from above

PTCA ( Multiple stenting )

• PRO – quicker, cheaper, and less immediate risks
• COns – a higher need for revascularization, Higher long-term risk of any secondary event, morbidity, and mortality.

CABG

• Pro – better protection in terms of long term mortality and lesser need of revascularisation
• Cons – Costlier, riskier process, Higher immediate risk.

there isn’t a clear choice here so the suggestion from cardiologists mostly stems from their personal preference.