Study Finds PCI Safe, Effective Despite Off-Site Cardi...( Quality of PCI p...),Health

Quality of PCI program is critical

CHICAGO, March 29 /PRNewswire/ -- Percutaneous coronary intervention (PCI) can be performed safely and successfully in medical centers without on-site cardiac surgical back-up, provided programs are well-organized, highly skilled and committed to quality. These are the findings of the largest clinical study ever to compare PCI programs that have on-site cardiac surgery to PCI programs that transfer patients to a surgical hospital in case of emergency.

The study was reported today in a Late-Breaking Clinical Trials session at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit (SCAI-ACCi2) in Chicago. SCAI-ACCi2 is a scientific meeting for practicing cardiovascular interventionalists sponsored by the Society for Cardiovascular Angiography and Interventions (SCAI) in partnership with the American College of Cardiology (ACC).

The study's findings, though reassuring, should not be interpreted as an endorsement of "boutique" angioplasty, said lead investigator Michael A. Kutcher, MD, director of interventional cardiology at Wake Forest University Health Sciences, Winston-Salem, NC.

"These medical centers are very accomplished and represent the premier programs offering PCI with off-site cardiac surgical back-up," Dr. Kutcher said. "And they are doing angioplasty for the right reasons: to improve outcomes for heart attack patients and to better serve patients in remote geographic areas."

Performing PCI at medical centers with off-site cardiac surgical back-up is controversial. Clinical guidelines accept this practice for patients who are experiencing a heart attack -- so-called primary PCI -- but advise against it in elective PCI, when the procedure is less urgent. However, medical centers that offer primary PCI argue they need to include elective PCI in the mix in order to survive economically and to keep staff skill levels high. Further complicating the issue:
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