ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention—Summary Article

Smith, Sidney C.; Feldman, Ted; Hirshfeld, John W.; Jacobs, Alice K.; Kern, Morton J.; King, Spencer B.; Morrison, Douglass A.; O’Neill, William W.; Schaff, Hartzell V.; Whitlow, Patrick L.; Williams, David O.; Antman, Elliott M.; Adams, Cynthia D.; Anderson, Jeffrey L.; Faxon, David P.; Fuster, Valentín; Halperin, Jonathan L.; Hiratzka, Loren F.; Hunt, Sharon A.; Nishimura, Rick A.; Ornato, Joseph P.; Page, Richard L.; Riegel, Bárbara

doi:10.1161/circulationaha.105.170815

Cited by 1,041 publications

(342 citation statements)

References 113 publications

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“…The mode of treatment was selected by surgeons and catheter interventionalists based on the procedural guidelines of the American College of Cardiology/American Heart Association (ACC/AHA). 13,14 Coronary artery bypass graft surgery was selected when significant stenotic or occlusive lesions were observed in all 3 epicardial branches, when the stenotic lesion involved the left main trunk, or when stenotic lesions were observed in 2 epicardial branches of which at least 1 was unsuitable for PCI (due to a chronic total occlusion or diffuse stenotic lesion). Percutaneous coronary intervention was selected when the patients had PCI-suitable stenotic lesion(s) in 1 or 2 branches.…”

Section: Introductionmentioning

confidence: 99%

Management of Coronary Artery Disease in Patients Undergoing Elective Abdominal Aortic Aneurysm Open Repair

Hosokawa¹,

Takano²,

Aoki³

et al. 2008

Clinical Cardiology

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Background The efficacy of prophylactic coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery in patients with abdominal aortic aneurysm (AAA) scheduled for open repair surgery remains controversial. Hypothesis Concomitant coronary artery disease (CAD) with no inducible ischemia can be medically treated in AAA patients undergoing open repair as long as the existence of CAD is recognized. Method A retrospective analysis of acute and long‐term outcomes was performed for 122 patients with AAA who underwent coronary arteriography (CAG) for preoperative evaluation followed by elective open repair. Results Preoperative CAG revealed no CAD in 54 patients (non‐CAD group) and the existence of CAD in 68 patients. Prophylactic PCI or CABG surgery was performed in 16 patients (CAD‐PCI/CABG group) with symptomatic angina, ischemia proven by pharmacological stress scintigraphy, or coexistence of reduced cardiac contraction and coronary stenosis in multiple vessels. Medical treatment was administered to 52 patients who had no signs of ischemia (CAD‐medical group). During the perioperative period, no cardiac event occurred irrespective of the existence of CAD. The long‐term outcomes in the CAD‐medical group were equivalent to those in the non‐CAD group. In the CAD‐PCI/CABG group, the cardiac event‐free rate was comparable with that of other groups, although mortality was higher. Conclusion In patients undergoing AAA open repair, medical treatment for concomitant CAD with no obvious inducible ischemia does not confer unfavorable outcomes. Although prophylactic coronary revascularization possibly prevents future cardiac events, it appears to be necessary in a very limited number of cases. Copyright © 2008 Wiley Periodicals, Inc.

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Section: Introductionmentioning

confidence: 99%

Management of Coronary Artery Disease in Patients Undergoing Elective Abdominal Aortic Aneurysm Open Repair

Hosokawa¹,

Takano²,

Aoki³

et al. 2008

Clinical Cardiology

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“…When the patient is eligible for CABG, PCI has a class III indication irrespective of the lesion location. 9 However, advances in intervention techniques and the use of DES are providing encouraging results in the treatment of LMCA stenosis. 10 In fact, DES have emerged as the favored percutaneous treatment modality for LMCA stenosis because of significant reductions in restenosis and TLR rates 11 as shown by a number of registries and nonrandomized studies that have demonstrated the effectiveness of DES for LMCA stenosis; 3 -5,12,13 however, there has been scant data available on long-term clinical follow-up in LMCA lesions treated with DES.…”

Section: Discussionmentioning

confidence: 99%

Two‐Year Outcomes of the Sirolimus‐Eluting Stent According to Unprotected Left Main Lesion

Kim

Park

Seol

et al. 2009

Clinical Cardiology

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Background: The data of long-term outcomes of sirolimus-eluting stent (SES) according to lesion location of unprotected left main coronary artery (LMCA) is scarce. Hypothesis: The purpose of this study was to evaluate the long-term outcomes after implantation of the SES in LMCA. Methods: A total of 84 patients (51 males) who had undergone SES implantation for the treatment of native LMCA stenosis were enrolled. The patients were divided into 2 groups based on angiographic lesion location: those with significant stenosis in the ostium and/or body (group 1; n = 39) and those involving bifurcation (group 2; n = 45). Results: All of the group 1 patients were treated with simple lesion coverage while different stenting techniques were used in group 2 (cross-over: 44.8%, T: 6.7%, kissing: 37.8%, and crush techniques: 11.1%). The 8-month quantitative angiographic findings and in-hospital and 2 year rates of major adverse cardiac events (MACE) were compared between the 2 groups. Although angiographic success and in-hospital MACE rates were similar in both groups with 1 cardiac death due to acute stent thrombosis in group 2, at 2-year follow-up, the MACE rate was significantly higher in group 2 than in group 1 at 2 years (22.2% vs 2.6%, respectively, P = 0.008). Coronary angiography revealed a significantly higher binary restenosis rate in group 2 compared with group 1 (20% vs 0%, respectively, P = 0.003). Conclusions: Interventional treatment using SES in left main lesions showed favorable short-term and longterm outcomes in selected patients with lesion location being an important determinant of clinical and angiographic outcomes. IntroductionPercutaneous coronary intervention (PCI) with drug-eluting stent (DES) has been associated with marked reductions in restenosis rates 1 and neointimal hyperplasia formation; 2 this also appears to be the case for the treatment of unprotected left main coronary artery (LMCA) lesions, 3 -5 an observation that stands in contrast with the fact that in the bare-metal stent era an LMCA lesion was a definite indication for coronary artery bypass graft (CABG) surgery. However, there is little data on the long-term outcomes according to LMCA lesion complexity and location and therefore this registry study was aimed at evaluating long-term clinical and angiographic outcomes according to LMCA lesion location post sirolimus-eluting stent (SES) implantation.

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“…The 2002 guidelines for the management of chronic stable angina [3] define 70% stenosis as significant. The 2004 coronary artery bypass graft surgery (CABG) guidelines [15] use 50%, and the 2005 PCI guidelines [16] state only that a lesion <50% is not significant. The European Society of Cardiology 2005 stable angina guidelines [17] do not provide a specific definition [16], whereas the European Society of Cardiology PCI guidelines define 50-70% stenosis as ''borderline'' significant [18].…”

Section: Identification Of Multivessel Coronary Disease Definitions Omentioning

confidence: 99%

“…The 2004 coronary artery bypass graft surgery (CABG) guidelines [15] use 50%, and the 2005 PCI guidelines [16] state only that a lesion <50% is not significant. The European Society of Cardiology 2005 stable angina guidelines [17] do not provide a specific definition [16], whereas the European Society of Cardiology PCI guidelines define 50-70% stenosis as ''borderline'' significant [18]. More recent guidelines define significant coronary disease as lesions >70% by angiography, or lesions that are hemodynamically significant by stress testing, fractional flow reserve (FFR), or intravascular ultrasound [19,20].…”

Section: Identification Of Multivessel Coronary Disease Definitions Omentioning

confidence: 99%

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Staging of multivessel percutaneous coronary interventions: An expert consensus statement from the Society for Cardiovascular Angiography and Interventions

Blankenship

Moussa

Chambers

et al. 2011

Cathet Cardio Intervent

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Percutaneous coronary interventions (PCIs) to treat multivessel coronary artery disease (MVCAD) may involve single-vessel or multivessel interventions, performed in one or more stages. This consensus statement reviews factors that may influence choice of strategy and includes six recommendations to guide decisions regarding staging of PCI [1]. Every patient who undergoes PCI should receive optimal therapy for coronary disease, ideally before starting the procedure [2]. Multivessel PCI at the time of diagnostic catheterization should be considered only if informed consent included the risks and benefits of multivessel PCI and the risks and benefits of alternative treatments [3]. When considering multivessel PCI, the interventionist should develop a strategy regarding which stenoses to treat or evaluate, and their order, method, and timing. This strategy should maximize patient benefits, minimize patient risk, and consider the factors described in this article [4]. For planned multivessel PCI, additional vessel(s) should be treated only if the first vessel is treated successfully and if anticipated contrast and radiation doses and patient and operator conditions are favorable [5]. After the first stage of the planned multistage PCI, the need for subsequent PCI should be reviewed before it is performed [6]. Third party payers and quality auditors should recognize that multistage PCI for MVCAD is neither an indication of poor quality nor an attempt to increase reimbursement when performed according to recommendations in this article.V C 2011 Wiley Periodicals, Inc.

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ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention—Summary Article

Cited by 1,041 publications

References 113 publications

Management of Coronary Artery Disease in Patients Undergoing Elective Abdominal Aortic Aneurysm Open Repair

Management of Coronary Artery Disease in Patients Undergoing Elective Abdominal Aortic Aneurysm Open Repair

Two‐Year Outcomes of the Sirolimus‐Eluting Stent According to Unprotected Left Main Lesion

Staging of multivessel percutaneous coronary interventions: An expert consensus statement from the Society for Cardiovascular Angiography and Interventions

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