Percutaneous coronary intervention non-left main coronary artery disease: Difference between revisions

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==ACCF/AHA 2011 Guidelines for Percutaneous Coronary Intervention: Revascularization to Improve Survival in Non-Left Main Coronary Artery Disease<ref name="pmid22070837">{{cite journal |author=Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH |title=2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=24 |pages=2550–83 |year=2011 |month=December|pmid=22070837|doi=10.1016/j.jacc.2011.08.006|url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02875-0|accessdate=2011-12-08|url=http://content.onlinejacc.org/cgi/reprint/58/24/2550.pdf|PDF}}</ref> (DO NOT EDIT)==
==2011 ACCF/AHA Guidelines for Percutaneous Coronary Intervention: Revascularization to Improve Survival in Non-Left Main Coronary Artery Disease<ref name="pmid22070837">{{cite journal |author=Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH |title=2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions |journal=[[Journal of the American College of Cardiology]] |volume=58 |issue=24 |pages=2550–83 |year=2011 |month=December|pmid=22070837|doi=10.1016/j.jacc.2011.08.006|url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02875-0|accessdate=2011-12-08|url=http://content.onlinejacc.org/cgi/reprint/58/24/2550.pdf|PDF}}</ref> (DO NOT EDIT)==


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Revision as of 19:17, 26 October 2012

Percutaneous Coronary Intervention Guidelines Microchapters

Home

Patient Information

Overview

PCI Approaches:

CAD Revascularization:

Heart Team Approach to Revascularization Decisions
Left Main Coronary Artery Disease
Intervention in left main coronary artery disease
Non-Left Main Coronary Artery Disease
Revascularization to Improve Symptoms
Dual Antiplatelet Therapy Compliance and Stent Thrombosis
Hybrid Coronary Revascularization

Pre-procedural Considerations:

Contrast-Induced Acute Kidney Injury
Anaphylactoid Reactions
Statin Treatment
Bleeding Risk
Role of Onsite Surgical Backup

Procedural Considerations:

Vascular Access
PCI in Specific Clinical Situations:
Asymptomatic Ischemia or CCS Class I or II Angina
CCS Class III Angina
Unstable Angina/Non–ST-Elevation Myocardial Infarction
ST-Elevation Myocardial Infarction:
General and Specific Considerations
Coronary Angiography Strategies in STEMI
Primary PCI of the Infarct Artery
Delayed or Elective PCI in patients with STEMI
Fibrinolytic-Ineligible Patients
Facilitated PCI
Rescue PCI
After Successful Fibrinolysis or for Patients Not Undergoing Primary Reperfusion
Cardiogenic Shock
Prior Coronary Bypass Surgery
Revascularization Before Non-cardiac Surgery
Adjunctive Diagnostic Devices:
Fractional Flow Reserve
Intravascular Ultrasound
Adjunctive Therapeutic Devices:
Coronary Atherectomy
Thrombectomy
Laser Angioplasty
Cutting Balloon Angioplasty
Embolic Protection Devices
Percutaneous Hemodynamic Support Devices
Antiplatelet therapy:
Oral Antiplatelet Therapy
Glycoprotein IIb/IIIa Receptor Antagonists
Intravenous Antiplatelet therapy:
STEMI
UA/NSTEMI
SIHD
Anticoagulant Therapy:
Parenteral Anticoagulants During PCI
Unfractionated Heparin
Enoxaparin
Bivalirudin and Argatroban
Fondaparinux
No-Reflow Pharmacological Therapies
PCI in Specific Anatomic Situations:
Chronic Total Occlusions
Saphenous Vein Grafts
Bifurcation Lesions
Aorto-Ostial Stenoses
Calcified Lesions
PCI in Specific Patient Populations:
Chronic Kidney Disease
Peri-procedural Myocardial Infarction Assessment
Vascular Closure Devices

Post-Procedural Considerations:

Post-procedural Antiplatelet Therapy
Proton Pump Inhibitors and Antiplatelet Therapy
Clopidogrel Genetic Testing
Platelet Function Testing
Restenosis
Exercise Testing
Cardiac Rehabilitation

Quality and Performance Considerations:

Quality and Performance
Certification and Maintenance of Certification
Operator and Institutional Competency and Volume

Percutaneous coronary intervention non-left main coronary artery disease On the Web

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Most cited articles

Review articles

CME Programs

Powerpoint slides

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All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Percutaneous coronary intervention non-left main coronary artery disease

CDC on Percutaneous coronary intervention non-left main coronary artery disease

Percutaneous coronary intervention non-left main coronary artery disease in the news

Blogs on Percutaneous coronary intervention non-left main coronary artery disease

Directions to Hospitals Treating Percutaneous Coronary Intervention

Risk calculators and risk factors for Percutaneous coronary intervention non-left main coronary artery disease

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2011 ACCF/AHA Guidelines for Percutaneous Coronary Intervention: Revascularization to Improve Survival in Non-Left Main Coronary Artery Disease[1] (DO NOT EDIT)

Class I

"1. CABG or PCI to improve survival is beneficial in survivors of sudden cardiac death with presumed ischemia-mediated ventricular tachycardia caused by significant (greater than or equal to 70% diameter) stenosis in a major coronary artery. (CABG (Level of Evidence: B) [2][3][4]; PCI (Level of Evidence: C) [2])"

Class III (Harm)

"1. CABG or PCI should not be performed with the primary or sole intent to improve survival in patients with stable ischemic heart disease with 1 or more coronary stenoses that are not anatomically or functionally significant (e.g., greater than 70% diameter non–left main coronary artery stenosis, fractional flow reserve 0.80, no or only mild ischemia on noninvasive testing), involve only the left circumflex or right coronary artery, or subtend only a small area of viable myocardium. [5][6][7][8][9][10][11][12][13](Level of Evidence: B)"

Class IIa

"1. It is reasonable to choose CABG over PCI to improve survival in patients with complex 3-vessel CAD (e.g., SYNTAX score greater than 22) with or without involvement of the proximal LAD artery who are good candidates for CABG. [14][15][16][17][18] (Level of Evidence: B)"

"2. CABG is probably recommended in preference to PCI to improve survival in patients with multivessel CAD and diabetes mellitus, particularly if a left internal mammary artery graft can be anastomosed to the LAD artery. [19][20][21][22][18][23][24][25][26] (Level of Evidence: B)"

Class IIb

"1. The usefulness of PCI to improve survival is uncertain in patients with 2- or 3-vessel CAD (with or without involvement of the proximal LAD artery) or 1-vessel proximal LAD disease. [27][6][14][28] (Level of Evidence: B)"

"2. The usefulness of CABG or PCI to improve survival is uncertain in patients with previous CABG and extensive anterior wall ischemia on noninvasive testing. [29][30][31][32][33][34][35][36][37] (Level of Evidence: B)"

References

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  2. 2.0 2.1 Borger van der Burg AE, Bax JJ, Boersma E, Bootsma M, van Erven L, van der Wall EE, Schalij MJ (2003). "Impact of percutaneous coronary intervention or coronary artery bypass grafting on outcome after nonfatal cardiac arrest outside the hospital". The American Journal of Cardiology. 91 (7): 785–9. PMID 12667561. Retrieved 2011-12-04. Unknown parameter |month= ignored (help)
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  5. Yusuf S, Zucker D, Peduzzi P, Fisher LD, Takaro T, Kennedy JW, Davis K, Killip T, Passamani E, Norris R (1994). "Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration". Lancet. 344 (8922): 563–70. PMID 7914958. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
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  13. Sawada S, Bapat A, Vaz D, Weksler J, Fineberg N, Greene A, Gradus-Pizlo I, Feigenbaum H (2003). "Incremental value of myocardial viability for prediction of long-term prognosis in surgically revascularized patients with left ventricular dysfunction". Journal of the American College of Cardiology. 42 (12): 2099–105. PMID 14680734. Retrieved 2011-12-04. Unknown parameter |month= ignored (help)
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  17. Kappetein AP, Feldman TE, Mack MJ, Morice MC, Holmes DR, Ståhle E, Dawkins KD, Mohr FW, Serruys PW, Colombo A (2011). "Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease: 3-year follow-up of the SYNTAX trial". European Heart Journal. 32 (17): 2125–34. doi:10.1093/eurheartj/ehr213. PMID 21697170. Retrieved 2011-12-04. Unknown parameter |month= ignored (help)
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  19. Sorajja P, Chareonthaitawee P, Rajagopalan N, Miller TD, Frye RL, Hodge DO, Gibbons RJ (2005). "Improved survival in asymptomatic diabetic patients with high-risk SPECT imaging treated with coronary artery bypass grafting". Circulation. 112 (9 Suppl): I311–6. doi:10.1161/CIRCULATIONAHA.104.525022. PMID 16159837. Retrieved 2011-12-04. Unknown parameter |month= ignored (help)
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