Complete versus culprit vessel percutaneous coronary intervention in multivessel disease: A randomized comparison

Ijsselmuiden, Alexander; Ezechiels, JanPaul; Westendorp, I. C. D.; Tijssen, Jan G.P.; Kiemeneij, Ferdinand; Slagboom, Ton; Wieken, Ron van der; Tangelder, G. J.; Serruys, Patrick W.; Laarman, Gert Jan

doi:10.1016/j.ahj.2004.03.026

Cited by 113 publications

(91 citation statements)

References 12 publications

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“…In agreement with the present study, Ijsselmuiden et al [13] investigated the major cardiac events at short and long term follow-up of multi-vessel versus culprit-vessel stenting in patients presenting with NSTE-ACS and multi-vessel disease (MVD). MACE rates at 1 month (14.4% vs 9.3%), 1 year (32.4% vs 26.9 %), and 4.6 +/-1.2 years (40.4% vs 34.6%) were similar in both groups.…”

Section: Discussionsupporting

confidence: 60%

Multivessel Stenting versus Culprit-Only Stenting in Multivessel Coronary Artery Disease Patients Presented with Non-ST-Segment Elevation Acute Coronary Syndrome (NSTE-ACS)

Salem¹

2015

JCCR

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Section: Discussionsupporting

confidence: 60%

Multivessel Stenting versus Culprit-Only Stenting in Multivessel Coronary Artery Disease Patients Presented with Non-ST-Segment Elevation Acute Coronary Syndrome (NSTE-ACS)

Salem¹

2015

JCCR

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“…In studies concerning the completeness of revascularisation, the angiographic profile is usually more favourable in the CR group [9,[15][16][17].…”

Section: Angiographic Characteristics and Procedures Safetymentioning

confidence: 99%

Complete percutaneous revascularisation feasibility in ischaemic heart failure is related to improved outcomes: insights from the COMMIT-HF registry

Pyka¹,

Hawranek²,

Tajstra³

et al. 2017

Kardiol Pol

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A b s t r a c tBackground and aim: Heart failure (HF) is a major cause of death in cardiovascular disease. In a post-STICH landscape, we lack data on the role of percutaneous coronary intervention (PCI) in systolic HF patients. Complete revascularisation remains a key unanswered question in ischaemic HF. Methods:The COMMIT-HF is an ongoing systolic HF registry (inclusion criteria: HF with left ventricular ejection fraction ≤ 35%, exclusion: acute coronary syndrome). A total of 1798 patients were enrolled. A group of patients with multi-vessel coronary artery disease qualified for PCI were selected and divided into complete (n = 188) and incomplete revascularisation (n = 159) groups. Completeness of revascularisation was defined as successful PCI of every angiographically significant lesion in all arteries with a diameter of ≥ 2 mm without a patent surgical graft. Patients were followed up for a period of at least 12 months with all-cause mortality defined as the primary endpoint. Results:The study groups showed no significant differences in clinical status and echocardiographic parameters, with a lower comorbidity rate in the complete revascularisation group. Procedural characteristics were comparable. There were no significant differences in complication rates. All-cause mortality was significantly lower in the complete revascularisation group after 12-months (6.4% vs. 20.1%, p < 0.001). Multivariate analysis confirmed that achievement of complete revascularisation was an independent factor improving survival (HR 0.39; 95% CI 0.18-0.81, p = 0.01). Conclusions:Percutaneous coronary intervention can be a safe and feasible method of revascularisation in ischaemic HF. Achievement of complete revascularisation with PCI was related to improved outcomes in the analysed patient population.

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“…However, the clinical benefits of CR using angiographic criteria are uncertain, with some [65,[67][68][69][70] but not all [71][72][73] studies reporting superior outcomes with CR. CR does reduce the incidence of subsequent CABG [66,74] or subsequent PCI [64] (Table II). CR using FFR testing to identify significant stenoses improved outcomes compared with CR based only on angiographic analysis [41].…”

Section: Strategies For Multivessel Pci Complete Versus Incomplete Rementioning

confidence: 99%

“…PCI studies have defined CR to include arteries with diameter greater than 1.5 [63], 2.0 [64], 2.25 [65], or 2.75 mm [66] with >50 or >70% stenoses. The Writing Group suggests the following definition of CR relevant to PCI: ''revascularization of all significant arteries (as assessed by the angiographer) that threaten viable myocardium with stenoses either >70% diameter narrowing by angiography or of hemodynamic significance by stress testing or invasive assessment.''…”

Section: Strategies For Multivessel Pci Complete Versus Incomplete Rementioning

confidence: 99%

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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Complete versus culprit vessel percutaneous coronary intervention in multivessel disease: A randomized comparison

Cited by 113 publications

References 12 publications

Multivessel Stenting versus Culprit-Only Stenting in Multivessel Coronary Artery Disease Patients Presented with Non-ST-Segment Elevation Acute Coronary Syndrome (NSTE-ACS)

Multivessel Stenting versus Culprit-Only Stenting in Multivessel Coronary Artery Disease Patients Presented with Non-ST-Segment Elevation Acute Coronary Syndrome (NSTE-ACS)

Complete percutaneous revascularisation feasibility in ischaemic heart failure is related to improved outcomes: insights from the COMMIT-HF registry

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

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