Ad hoc coronary intervention

2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention

“…When informed consent for PCI is obtained before diagnostic catheterization is performed, it is impossible to predict the levels of risk and benefit from an ad hoc PCI. 310,311 If diagnostic catheterization reveals anatomy that poses a particularly high risk or for which the superiority of PCI compared with other strategies is unclear, the precatheterization informed consent discussion may be inadequate. In such cases, deferral of PCI until additional informed consent discussions and/or consultations occur may be appropriate, even though it inconveniences the patient and the healthcare system.…”

2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention

“…Ad hoc PCI, or PCI immediately following diagnostic procedures, presents special problems. When informed consent for PCI is obtained before diagnostic catheterization is performed, it is impossible to predict the levels of risk and benefit from an ad hoc PCI (310,311). If diagnostic catheterization reveals anatomy that poses a particularly high risk or for which the superiority of PCI compared with other strategies is unclear, the precatheterization informed consent discussion may be inadequate.…”

ACC/AHA/SCAI Practice Guidelines, February 21, 2006

“…Ad hoc PCI should be performed only in a wellinformed patient, particularly in the setting of single-vessel disease without morphologic features predictive of an adverse outcome, when it is clear that this treatment strategy is the best alternative. However, ad hoc percutaneous revascularization should not be performed in patients in whom the angiographic findings are unanticipated or in whom the indication, suitability, or preference for percutaneous revascularization is unclear (823). Patient safety should be the paramount consideration when ad hoc intervention is being considered.…”