Staged PCI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Staged PCI is referred to the performance of a percutaneous coronary intervention (PCI) at a later date separate from the performance of the diagnostic catheterization or the performance of an initial PCI.
Guidelines Regarding Staged PCI
Performance of PCI in a non-culprit artery at the time of a ST elevation MI (STEMI) is a class III contraindication. Only 2% of interventional cardiologist would perform a PCI in a non-culprit vessel in the setting of STEMI in a patient who is hemodynamically stable [1]. The need for and the timing of staged PCI among patients with unstable angina (UA) or non ST elevation MI (NSTEMI) and stable angina is less clear.
Timing of a Staged PCI
STEMI
62% of interventional cardiologists recommend that the PCI of the non-culprit artery be performed more than 15 days after the STEMI [2].
UA / NSTEMI
There is less of a consensus regarding the optimal timing of a staged PCI among UA / NSTEMI patients. 55% of surveyed cardiologists recommend waiting > 2 weeks following the initial revascularization to perform the next PCI, while 22% recommended that the additional PCI be performed during the same hospitalization as the initial revascularization.
Stable Angina
Among patients with stable angina, 64% of surveyed cardiologist recommend waiting ≥ 15 days to perform the second PCI following the initial revascularization while 35% recommend performance of PCI within 2 weeks of the initial revascularization.