The 2010 ESC/EACTS guidelines on myocardial revascularisation

Taggart, David P.; Boyle, Roger; Belder, Mark de; Fox, Keith A.A.

doi:10.1136/hrt.2010.216135

Cited by 57 publications

(38 citation statements)

References 7 publications

(8 reference statements)

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“…An attempt to expand the artery "at all costs" by using highpressure non-compliant balloons (above 20 atm) may end with rupture of the balloon or the occurrence of the socalled hourglass phenomenon -an excessive expansion of the balloon catheter directly before and after the lesion with a risk of an extensive dissection and even perforation of the vessel. Therefore in our center patients in whom balloon angioplasty using relatively safe pressures (about 16 atm) was ineffective are qualified for the rotablation procedure, which is consistent with the ESC guidelines [2]. Rotablation procedures are often performed ad hoc, but it should be noted that they are associated with an additional radiation exposure and the use of larger amounts of the contrast medium, which, taking into account the patient's history, was a decisive factor for postponement of the procedure until implementation of the optimal prevention of contrast-induced nephropathy (CIN).…”

Section: Discussionmentioning

confidence: 54%

“…Guidelines of the European Society of Cardiology (ESC) recommend rotablation as a method of "last resort" (bailout technique) in the case of lesions that cannot be crossed with a balloon or adequately expanded before stenting [2]. However, there are some reported cases of routine use of this technique to reduce the volume of atherosclerotic plaque before the angioplasty and in other indications, such as side-branch protection, support for the treatment of chronic total occlusions (CTO) or even in the treatment of in-stent restenosis [3].…”

Section: Introductionmentioning

confidence: 99%

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Rotational atherectomy of right coronary artery complicated with stent dislodgment and ostial dissection –

Zimoch¹,

Gaul²,

Wojtczak³

et al. 2012

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Rotational atherectomy of right coronary artery complicated with stent dislodgment and ostial dissection –

Zimoch¹,

Gaul²,

Wojtczak³

et al. 2012

pwki

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“…A recent US study of revascularisation procedures during 2001e2008 showed a 38% decline in rates of CABG, while PCI decreased by only 4%. 9 Some have questioned whether patients are being appropriately advised according to contemporary guidelines, 10 a US analysis of 500 154 PCIs reporting that, among the 28.9% of cases performed for non-acute indications, only 50.4% were appropriate and that angina was not present in many of the inappropriate cases. 11 In the absence of any evidence of prognostic benefit, there can be no indication for PCI in stable patients without angina.…”

Section: Pci Versus Coronary Bypass Surgerymentioning

confidence: 99%

Almanac 2012: Interventional cardiology

Meier

2013

Revista Portuguesa de Cardiologia (English Edition)

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The field of interventional cardiology continues to progress quickly. The efficacy of percutaneous interventions with newer generation drug-eluting stents has advanced a lot over the last decade. This improvement in stent performance has broadened the level of indication towards more complex interventions such as left main and multivessel PCI. Major improvements continue in the field of medical co-therapy such as antiplatelet therapies (bivalirudin, prasugrel, ticagrelor) and this will further improve outcomes of PCI. The same is true for intravascular imaging such as ultrasound IVUS and optical coherence tomography OCT. However, interventional cardiology has become a rather broad field, also including alcohol septal ablation for hypertrophic obstructive cardiomyopathy, etc. At the moment, the fastest growing area is the structural interventions, especially for aortic valve stenosis (transcatheter aortic valve implantation TAVI) and for mitral regurgitation (mitral clipping). This review covers recent advances in all these different fields of interventional cardiology. PERCUTANEOUS CORONARY INTERVENTION VERSUS MEDICAL TREATMENTPercutaneous coronary intervention (PCI) has guideline recommendations for treatment of ST elevation and non-ST elevation myocardial infarction (MI). 1 However, its role in stable coronary disease has been the subject of reappraisal following publication of the COURAGE trial, which showed that, in patients receiving optimal medical therapy, PCI does not improve cardiovascular outcomes, while incremental benefits for quality of life disappear by 36 months. A more recent meta-analysis of eight trials of optimal medical therapy versus PCI involving 7229 patients bears out the COURAGE conclusions by showing no significant differences between the groups with regard to death (9.1% vs 8.9%), non-fatal MI (8.1% vs 8.9%), unplanned revascularisation (30.7% vs 21.4%) and persistent angina (33% vs 29%).4 Drug-eluting stents (DESs) were used in only a minority of these patients and may have reduced the need for further revascularisation while improving symptomatic responses. Nevertheless, the meta-analysis reinforces contemporary guideline advice for optimal medical treatment as the initial treatment for stable angina.

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“…A recent US study of revascularisation procedures during 2001-2008 showed a 38% decline in rates of CABG, while PCI decreased by only 4%. 9 Some have questioned whether patients are being appropriately advised according to contemporary guidelines, 10 a US analysis of 500 154 PCIs reporting that, among the 28.9% of cases performed for non-acute indications, only 50.4% were appropriate and that angina was not present in many of the inappropriate cases. 11 In the absence of any evidence of prognostic benefit, there can be no indication for PCI in stable patients without angina.…”

Section: Pci Versus Coronary Bypass Surgerymentioning

confidence: 99%

Almanac 2012: Cardiovascular risk scores: The national society journals present selected research that has driven recent advances in clinical cardiology

Meier¹

2013

Srce i krvni sudovi

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Almanah 2012 serijaPercutaneous coronary intervention versus medical treatment P ercutaneous coronary intervention (PCI) has guide line recommendations for treatment of ST elevation and non-ST elevation myocardial infarction (MI).1 However, its role in stable coronary disease has been the subject of reappraisal following publication of the COURAGE trial, which showed that, in patients receiving optimal medical therapy, PCI does not improve cardiovascular outcomes, while incremental benefits for quality of life disappear by 36 months.2 3 A more recent meta-analysis of eight trials of optimal medical therapy versus PCI involving 7229 patients bears out the COURAGE conclusions by showing no significant differences between the groups with regard to death (9.1% vs 8.9%), non-fatal MI (8.1% vs 8.9%), unplanned revascularisation (30.7% vs 21.4%) and persistent angina (33% vs 29%).4 Drug-eluting stents (DESs) were used in only a minority of these patients and may have reduced the need for further revascularisation while improving symptomatic responses. Nevertheless, the meta-analysis reinforces contemporary guideline advice for optimal medical treatment as the initial treatment for stable angina.5 Whether this will change current practice remains to be seen, but early signs are not encouraging. Thus a US registry analysis of patients undergoing PCI before (n=173416) and after (n=293 795) the COURAGE report showed no change in the proportions receiving optimal medical treatment (43.5% vs 44.7%). 6 PCI versus coronary bypass surgery

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The 2010 ESC/EACTS guidelines on myocardial revascularisation

Cited by 57 publications

References 7 publications

Rotational atherectomy of right coronary artery complicated with stent dislodgment and ostial dissection –

Rotational atherectomy of right coronary artery complicated with stent dislodgment and ostial dissection –

Almanac 2012: Interventional cardiology

Almanac 2012: Cardiovascular risk scores: The national society journals present selected research that has driven recent advances in clinical cardiology

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