Percutaneous coronary intervention after successful fibrinolysis or for patients not undergoing primary reperfusion
Percutaneous Coronary Intervention Guidelines Microchapters |
PCI Approaches: |
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CAD Revascularization: |
Pre-procedural Considerations: |
Procedural Considerations: |
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Post-Procedural Considerations: |
Quality and Performance Considerations: |
Percutaneous coronary intervention after successful fibrinolysis or for patients not undergoing primary reperfusion On the Web |
American Roentgen Ray Society Images of Percutaneous coronary intervention after successful fibrinolysis or for patients not undergoing primary reperfusion |
Directions to Hospitals Treating Percutaneous Coronary Intervention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
2007 Focused Update of the ACCF/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: PCI After Successful Fibrinolysis or for Patients Not Undergoing Primary Reperfusion[1](DO NOT EDIT)
Class I |
"1. In patients whose anatomy is suitable, PCI should be performed when there is objective evidence of recurrent MI. (Level of Evidence: C)" |
"2. In patients whose anatomy is suitable, PCI should be performed for moderate or severe spontaneous or provocable myocardial ischemia during recovery from STEMI. (Level of Evidence: B)" |
"3. In patients whose anatomy is suitable, PCI should be performed for cardiogenic shock or hemodynamic instability. (Level of Evidence: B) |
Class III |
"1. PCI of a totally occluded infarct artery greater than 24 hours after STEMI is not recommended in asymptomatic patients with 1- or 2-vessel disease if they are hemodynamically and electrically stable and do not have evidence of severe ischemia. (Level of Evidence: B)" |
Class IIa |
"1. It is reasonable to perform routine PCI in patients with LV ejection fraction less than or equal to 0.40, heart failure, or serious ventricular arrhythmias. (Level of Evidence: C)" |
"2. It is reasonable to perform PCI when there is documented clinical heart failure during the acute episode, even though subsequent evaluation shows preserved LV function (LV ejection fraction greater than 0.40). (Level of Evidence: C)" |
Class IIb |
"1. PCI might be considered as part of an invasive strategy after fibrinolytic therapy. (Level of Evidence: C)" |
2005 ACC/AHA/SCAI Guidelines for Percutaneous Coronary Intervention: PCI in Fibrinolytic-Ineligible Patients[2](DO NOT EDIT)
Class I |
"1.Primary PCI should be performed in fibrinolytic-ineligible patients who present with STEMI within 12 hours of symptom onset. (Level of Evidence: C) " |
Class IIa |
"'1.It is reasonable to perform primary PCI for fibrinolytic- ineligible patients with onset of symptoms within the prior 12 to 24 hours and 1 or more of the following:
a. Severe congestive heart failure. (Level of Evidence: C) b. Hemodynamic or electrical instability. (Level of Evidence: C) c. Evidence of persistent ischemia. (Level of Evidence: C) |
References
- ↑ King SB, Smith SC, Hirshfeld JW, Jacobs AK, Morrison DA, Williams DO; et al. (2008). "2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: 2007 Writing Group to Review New Evidence and Update the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention, Writing on Behalf of the 2005 Writing Committee". Circulation. 117 (2): 261–95. doi:10.1161/CIRCULATIONAHA.107.188208. PMID 18079354.
- ↑ Smith SC, Feldman TE, Hirshfeld JW, Jacobs AK, Kern MJ, King SB; et al. (2006). "ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update 2001 Guidelines for Percutaneous Coronary Intervention)". Circulation. 113 (7): e166–286. doi:10.1161/CIRCULATIONAHA.106.173220. PMID 16490830.