Tag Archives: percutaneous coronary intervention (PCI)

Introduction While undertaking percutaneous coronary intervention (PCI) at a tertiary-care cardiology suite, radial artery access (RAA) has demonstrated the advantage of reduced bleeding-related complications as compared with the traditional femoral artery access.1 The utilisation of RAA has significantly increased, with a majority of UK hospitals adopting this approach as the preferred method. The National Institute for Cardiovascular Outcomes Research (NICOR) national dataset reported that in 2015, up to 80.5% of cases were undertaken via the RAA route, which was a significant rise from 2004 (10.2%).2 Compared with femoral angiography, rad

Introduction Over the past two decades, extensive debates continued to be held to determine the minimum annual percutaneous coronary intervention (PCI) numbers an interventional healthcare institution must meet in order to maintain high-quality performance and ensure patient safety throughout the entirety of patients’ hospital stay. While PCI procedures have become routine, they remain quite complex and potentially risky. Operators’ expertise, cardiac catheter laboratory (Cathlab) team competence and equipment readiness, coronary care unit (CCU) preparedness, and cardiac surgery availability or accessibility, are all essential factors tha

Introduction Delays in treatment following ST-elevation myocardial infarction (STEMI) influence patient outcomes. During the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) pandemic, delays in treatment may have altered outcomes of STEMI patients, even in those not infected by COVID-19. On 11 March 2020, the World Health Organisation declared COVID-19 a global pandemic.1 The UK government mandated social distancing on 16 March 2020, and imposed a nationwide lockdown on 23 March 2020.2 Primary percutaneous coronary intervention (PCI) remained our centre’s treatment of choice for STEMI, with thrombolys

Introduction According to the British Heart Foundation (BHF), in the UK there are more than 100,000 hospital admissions each year due to ST-elevation myocardial infarction (STEMI), equating to 280 admissions each day, or one every five minutes.1 The Essex cardiothoracic centre (CTC) is a tertiary, state-of-the-art centre that is equipped to deal with these high-risk cases. There are five district hospitals covered by the Essex CTC to provide a primary percutaneous coronary intervention (PCI) service. The patient turnover is high and there are emergency and elective procedures undertaken every day. The discharge of patients needs to be timely

The evidence COURAGE This study compared PCI plus optimal medical therapy with optimal medical therapy alone. There were 2,287 patients enrolled: 1,149 patients were equally randomised to receive PCI or medical therapy, testing all-cause mortality and myocardial infarction (MI) over a median of 4.6 years. The cumulative primary-event rates were not significantly different between the two groups (p=0.62). The same was the case for the composite of death, MI, and stroke (p=0.62); acute coronary syndrome (ACS) hospitalisation (p=0.56), or MI (p=0.33). The trial concluded that elective PCI confers no prognostic benefit over medical therapy alone.

Case report Figure 1. A. Intravascular ultrasound (IVUS) showing a well-apposed stent in the first diagonal (D1) B. IVUS showing cup of Sideguard® slightly protruding into left anterior descending (LAD) (arrow) C. Optical coherence tomography (OCT) showing a well-endothelialised stent in the D1 D. OCT showing a migrated and well-endothelialised stent in the LAD A 43-year-old male with a past medical history of severe asthma and transient ischaemic attack presented with exertional angina and a normal electrocardiogram (ECG). Coronary angiography demonstrated minor plaque disease in the proximal left anterior descending artery (LAD) and ostial

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