Relation Between Operator and Hospital Volume and Outcomes Following Percutaneous Coronary Interventions in the Era of the Coronary Stent

Abstract

In the era of coronary stents, Medicare patients treated by high-volume physicians and at high-volume centers experience better outcomes following PCIs.

Stent and Dual Antiplatelet Therapy Duration Comparisons in the Setting of a Multicenter Randomized Controlled Trial: Can the Operator Experience Affect the Study Results?

“…Patients treated by high‐volume operators and at high‐volume centers have been shown to experience a higher rate of procedural success and lower rates of mortality and postprocedural complications 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11. As a consequence, standards of assistance have been recommended for PCI operators 1, 2, 6.…”

“…Although patient‐related factors are known to play a key role for those occurrences, it is currently unknown to which degree these adverse events may be also operator dependent. Overall number of procedures performed and the operator experience may affect outcomes of patients undergoing PCI, but this evidence is mainly based on observational studies 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11. Randomized, controlled trials have played a major role in informing the community on the incidence, predictors, and implications of PCI‐related adverse events.…”

Mechanical Thrombectomy-Ready Comprehensive Stroke Center Requirements and Endovascular Stroke Systems of Care: Recommendations from the Endovascular Stroke Standards Committee of the Society of Vascular and Interventional Neurology (SVIN)

“…Patient outcomes in disease processes such as acute trauma [18], STEMI [19] and aSAH [20,21] have been shown to be superior at high-volume facilities. Similarly, higher-volume endovascular stroke centers have lower times to reperfusion and better outcomes with MT [22].…”

Transatlantic perspectives on TAVI: from essential infrastructure and integration to expansion, research and development: Table 1

“…TAVI is a procedure with a significant learning curve,15 and previous data concerning percutaneous coronary procedures suggest that high volume operators and centres have significantly fewer complications than their low volume counterparts (particularly for higher risk procedures) 16. Although it remains unclear how much experience is sufficient, TAVI should currently be limited to centres initiating their programme under the observation of experienced operators and with a subsequent procedural volume affording frequent and routine exposure for all team members.…”