Percutaneous coronary intervention in the UK: recommendations for good practice 2015

Abstract

Over the last 35 years, there has been dramatic progress in the technology and applicability of percutaneous techniques to treat obstructive coronary heart disease. Percutaneous coronary intervention (PCI) has a considerable evidence base and it is firmly established as the most common procedure used in the invasive treatment of patients with coronary heart disease in the UK. This set of guidelines aims to address specifically issues relating to PCI and not the growing subspecialty of structural heart disease intervention. It is not intended to provide a review of the entire evidence base for coronary intervention. The evidence base relating to PCI is extensively reviewed in international guidelines and the British Cardiovascular Intervention society endorses these guidelines and their updates. The guidelines presented here focus on issues pertinent to practice within the UK and set out a recommended template to ensure optimal delivery of patient care.

The Current Status of Percutaneous Coronary Intervention in Korea: Based on Year 2014 Cohort of Korean Percutaneous Coronary Intervention (K-PCI) Registry

“…This registry records data on patient and hospital characteristics, clinical presentation, length of hospital stay, treatment information, and in-hospital outcomes for PCI procedures from >1000 sites across the United States. Several European countries are now conducting nationwide interventional registries that are organized either by a scientific society or the government 16)17)18)19)20). However, patterns for Korean PCI practice have differed, compared to western countries, therefore a Korean database that reflects relevant situations in Korea is needed.…”

Coronary Artery Bypass Graft Surgery and Dementia Risk in the Cardiovascular Health Study

“…Given that our results suggest the increased dementia risk associated with CABG takes >1 year to become apparent, it is possible that these mechanisms reduce brain reserve and increase vulnerability to dementia by accelerating cognitive decline. Moreover, CABG is performed under general anesthesia, whereas PCI often requires no sedation or conscious sedation 37. Results of studies investigating the association between general anesthesia and dementia risk are mixed.…”

A retrospective study of radiation dose measurements comparing different cath lab X‐ray systems in a sample population of patients undergoing percutaneous coronary intervention for chronic total occlusions

“…A variety of consensus documents recommend that quality assurance and quality improvement systems and processes should be standard for all cardiac catheter laboratory equipped facilities . Components of these programs include: clinical proficiency, equipment management/maintenance, peer review/data submission for bench‐marking and optimization of radiation safety for patients as well as staff . It is important to effectively measure radiation doses acquired by patients and cath lab personnel in order to minimize potentially harmful stochastic or deterministic effects.…”

“…A variety of consensus documents recommend that quality assurance and quality improvement systems and processes should be standard for all cardiac catheter laboratory equipped facilities [5][6][7].…”