SCAI Interventional Cardiology Board Review by Morton J. Kern

Author:Morton J. Kern
Language: eng
Format: epub
Tags: Medical
Publisher: Lippincott Williams & Wilkins
Published: 2014-04-14T04:00:00+00:00

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The ACC/AHA definition of a “successful” PCI can be classified into three categories: angiographic, procedural, and clinical success. Each of these should be carefully considered when approaching a high-risk coronary intervention.

Clinical variables of risk predict clinical outcomes, while anatomic lesion characteristics predict angiographic success.

The ACC/AHA and SCAI Lesion classification systems remain highly relevant in the modern era for grading the likelihood of technical success.

The Mayo Clinic Clinical Scoring system demonstrates a high predictive value for identifying complications associated with PCI.

The overall goals of percutaneous mechanical support devices are to: (a) maintain vital organ perfusion, (b) improve native cardiac output by reducing intracardiac filling pressures, (c) reduce LV volumes, wall stress and myocardial oxygen consumption, and (d) augment coronary perfusion during high-risk PCI.

Based on emerging data and experience, the updated PCI guidelines have recently incorporated hemodynamic support devices as an adjunct to HR-PCI in select cases, as a Class 2B recommendation.

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