The Society for Cardiovascular Angiography and Interventions (SCAI) has published a position statement addressing optimal percutaneous coronary intervention (PCI) treatment of patients with complex coronary artery disease (CAD).
The position statement was presented today during the SCAI 2020 Scientific Sessions Virtual Conference and published in SCAI's official journal, Catheterization and Cardiovascular Interventions.
While complex PCI has not yet been fully defined, this patient group presents both complex anatomic lesions and clinical parameters including advanced age, frailty, comorbidities, compromised hemodynamic status, depressed ventricular function and concomitant valvular disease. These factors increase both the procedural complexity of percutaneous coronary intervention (PCI) and the risk of adverse patient outcomes.
Over the last several years, there has been an increase in the anatomic and physiologic complexity of patients presenting to the catheterization lab. During that time, a multitude of tools have been developed to aid defining and treating this group when percutaneous revascularization is indicated. However, this population has been incompletely defined up to this point and there is a need to provide a contemporary evidence-based document that specifically addresses aspects of complex PCI in this patient group."
Robert F. Riley, MD, FSCAI, member of the document writing group, and research and medical director, Complex Coronary Therapeutics Program at The Christ Hospital
In the position statement, a multidisciplinary group of experts provide a state-of-the art update addressing evidence regarding PCI in patients with complex clinical and anatomical features and provide procedural guidance to achieve optimal outcomes for this challenging patient group. The document examines pre-procedural assessment of coronary anatomical complexity and higher-risk clinical features and interventional treatment of complex CAD.
"This document further complements the concomitantly published SCAI statement on the performance of PCI in ambulatory surgical centers. Together, we hope these documents will provide guidance on best practices and the performance settings for PCI across the spectrum of clinical and anatomical complexity," Riley concludes.
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