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Chapter-065 Guidelines for PCI 2014: Training for Percutaneous Coronary Intervention Appropriateness, Indications and Directions

BOOK TITLE: CSI: Cardiology Update 2014

Author
1. Dhall Anil
2. Chiwane Sanjat S
ISBN
9789351526186
DOI
10.5005/jp/books/12415_66
Edition
1/e
Publishing Year
2015
Pages
11
Author Affiliations
1. Artemis Health Institute, Gurgaon, Haryana, India, Max Devki Devi Heart and Vascular Institute, 2, Press Enclave Road, Saket, New Delhi, India, Sarvodaya Hospital & Research Centre, Faridabad, Haryana, India, Sarvodaya Hospital and Research Center, Gurgaon, Haryana, India, Venkateshwar Hospital, New Delhi, India, Delhi Heart and Lung Institute, New Delhi, India, Janakpuri Super Speciality Hospital, New Delhi, India, Janakpuri Superspecialty Hospital, New Delhi, India
Chapter keywords
Percutaneous coronary intervention, on-site surgery, oncology, turf protection, coronary revascularization, drug-eluting stents, stenosis, chronic total coronary occlusion, bioresorbable vascular scaffolds, invasive diagnostics, saphenous vein graft disease

Abstract

Percutaneous coronary intervention (PCI) represents the perfect paradigm of medical technology and innovation triumphing over adversity to deliver minimally invasive treatments to patients who previously received surgery or conservative management. The performance of PCI without on-site surgery in the US and European countries has gained greater acceptance, and questions about its safety in the presence of a proven, well defined, and protocol driven approach have diminished. Oncology practice world over have embraced multidisciplinary approach, this has not yet been accepted for coronary indications. Turf protection, logistical issues, interpersonal ego, logistics and lack of experience are some of the reasons. Yet, clearly there is a need for improved decision making and Heart Team seems to be the way ahead. Underutilization, overutilization and inappropriate use of coronary revascularization are common, and rates differ significantly between geographic regions and hospitals. We are moving towards “optimal functional revascularization”.

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