Document Detail


How good are experienced interventional cardiologists in predicting the risk and difficulty of a coronary angioplasty procedure? A prospective study to optimize surgical standby.
MedLine Citation:
PMID:  10348119     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prediction of the risk of a percutaneous transluminal coronary angioplasty has either been based on coronary lesion morphology or on clinical parameters, but a combined angiographic and clinical risk assessment system has not yet been evaluated prospectively. Five experienced interventionalists categorized 7,144 patients with 10,081 stenoses (1.4 lesion/patient) for both the risk and the difficulty of the procedure. Risk categories are as follows: 1 = low risk; 2 = intermediate risk; 3 = high risk. This division was made for percutaneous transluminal coronary angioplasty planning purposes. Category 1 patients denotes those in whom surgical standby is not required; category 2 patients, surgical standby not required but available within 1 hr; category 3 patients, surgical standby required. Difficulty categories are as follows: 1 = easy lesion; 2 = moderately difficult lesion; 3 = difficult lesion. Success was defined as a reduction of the degree of stenosis to less than 50%, without acute myocardial infarction, emergency redilatation, emergency bypass grafting, or death within 1 week. The procedure was not successful in difficulty category 1 in 1.6%, in category 2 in 3.5%, and in category 3 in 9.9%. Complications occurred in risk category 1 in 3.5%, in category 2 in 5.2%, and in category 3 in 12.4%. All differences were statistically significant (P < 0.05). Experienced cardiologists can well predict the risk and success of a coronary angioplasty procedure. This helps to optimize surgical standby, although even in the lowest-risk category complications can occur.
Authors:
B R Brueren; E G Mast; M J Suttorp; J M Ernst; E T Bal; H W Plokker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  46     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-07-06     Completed Date:  1999-07-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  257-62     Citation Subset:  IM    
Affiliation:
Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects
Cardiology Service, Hospital / standards
Clinical Competence
Coronary Angiography
Coronary Disease / classification,  radiography,  surgery,  therapy*
Female
Humans
Male
Middle Aged
Myocardial Revascularization
Netherlands
Outcome Assessment (Health Care) / standards*,  statistics & numerical data
Prospective Studies
Risk Assessment / standards*,  statistics & numerical data
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 1999 Mar;46(3):263-4   [PMID:  10348120 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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