SCAI/ACC/AHA Expert Consensus Document
Why the study?
Does performing PCI without on-site surgical backup result in similar mortality and MACE compared to PCI with on-site surgical backup in patients requiring coronary revascularization?
Population
Patients undergoing primary or elective percutaneous coronary intervention (PCI)
Comparison
PCI at facilities without on-site surgical backup vs PCI at facilities with on-site surgical backup
Design
Guideline
Authors
Discussion
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Member takes
Implication
Supports PCI without on-site surgery; extends observational data but leaves practice change to prospective trials.
Structured PICO
Does performing PCI without on-site surgical backup result in similar mortality and MACE compared to PCI with on-site surgical backup in patients requiring coronary revascularization?
P
Population
Expert consensus document reviewing the literature and providing recommendations for performing percutaneous coronary intervention without on-site surgical backup in the United States.
I
Intervention
PCI at facilities without on-site surgical backup
C
Comparator
PCI at facilities with on-site surgical backup
O
Outcome
Mortality and major adverse cardiac events (MACE)
This expert consensus document outlines updated recommendations and facility requirements for performing primary and elective PCI without on-site surgical backup, supported by evidence of non-inferior outcomes.
Cite This Study
Dehmer et al. (2014) conducted a review in Coronary artery disease requiring percutaneous coronary intervention. Percutaneous coronary intervention without on-site surgical backup vs. Percutaneous coronary intervention with on-site surgical backup was evaluated. PCI without on-site cardiac surgery is supported by expert consensus, with cited trials showing noninferior 6-week mortality (0.9% vs 1.0%, P=0.004) compared to sites with on-site surgery.