Percutaneous coronary intervention revascularization to improve symptoms
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Percutaneous Coronary Intervention Guidelines Microchapters |
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PCI Approaches: |
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CAD Revascularization: |
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Pre-procedural Considerations: |
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Procedural Considerations: |
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Post-Procedural Considerations: |
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Quality and Performance Considerations: |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
ACCF/AHA 2011 Guidelines for Percutaneous Coronary Intervention: Revascularization to Improve Symptoms (DO NOT EDIT)[1]
| Class I |
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"1. CABG or PCI to improve symptoms is beneficial in patients with 1 or more significant (greater than 70% diameter) coronary artery stenoses amenable to revascularization and unacceptable angina despite guideline-directed medical therapy. (Level of Evidence: A)" |
| Class IIa |
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"1. CABG or PCI to improve symptoms is reasonable in patients with 1 or more significant (greater than 70% diameter) coronary artery stenoses and unacceptable angina for whom guideline-directed medical therapy cannot be implemented because of medication contraindications, adverse effects, or patient preferences. (Level of Evidence: C)" |
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"2. PCI to improve symptoms is reasonable in patients with previous CABG, 1 or more significant (greater than 70% diameter) coronary artery stenoses associated with ischemia, and unacceptable anginadespite guideline-directed medical therapy. (Level of Evidence: C)" |
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"3. It is reasonable to choose CABG over PCI to improve symptoms 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. (Level of Evidence: B)" |
| Class IIb |
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"1. CABG to improve symptoms might be reasonable for patients with previous CABG, 1 or more significant (greater than 70% diameter) coronary artery stenoses not amenable to PCI, and unacceptable angina despite guideline-directed medical therapy. (Level of Evidence: C)" |
| Class III (Harm) |
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"1. CABG or PCI to improve symptoms should not be performed in patients who do not meet anatomic (greater than 50% left main or greater than 70% non–left main stenosis) or physiological (e.g., abnormal fractional flow reserve) criteria for revascularization. (Level of Evidence: C)" |
References
- ↑ Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B; et al. (2011). "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". Circulation. 124 (23): 2574–609. doi:10.1161/CIR.0b013e31823a5596. PMID 22064598.