The current status and future direction of percutaneous coronary intervention without on‐site surgical backup: An expert consensus document from the Society for Cardiovascular Angiography and Interventions

Abstract

The Society for Cardiovascular Angiography and Interventions (SCAI) coauthored and cosponsored with the American College of Cardiology (ACC) and the American Heart Association (AHA) the percutaneous coronary intervention (PCI) guidelines update, released in November 2005 [1]. This guideline update continued to designate elective PCI without on-site surgery as a Class III indication, and primary PCI for ST-segment elevation myocardial infarction (STEMI) as a class IIb indication in the absence of on-site surgery. The performance of PCI without on-site surgical backup is currently the subject of debate. Although providing the highest quality of care and best outcomes to patients should always be the primary goal, debate on this topic has the potential to supersede quality of patient care issues. Within this context, SCAI developed this Expert Consensus document to determine the current status of PCI without on-site surgery not only in the United States, but globally, and make recommendations regarding the performance of PCI in this circumstance. The focus of this document is to provide a structure that provides the highest quality care to patients undergoing PCI in any circumstance. Endorsed by the following societies: Asian Pacific Society of Interventional Cardiology, Belgian Working Group of Interventional Cardiology, Brazilian Society for Interventional Cardiology, British Cardiovascular Intervention Society, Working Group on Interventional Cardiology of the Bulgarian Cardiology Society, Cardiac Society of Australia and New Zealand, Egyptian Society of Cardiology Working Group on Interventional Cardiology, Interventional Council of the Cardiological Society of India, Italian Society of Interventional Cardiology, Working Group on Interventional Cardiology of the Latvian Society of Cardiology, Polish Working Group on Interventional Cardiology of the Polish Cardiology Society, Sociedad Venezolana de Cardiologia Intervencionista (Venezuelan Society of Interventional Cardiology). Texas A&M School of Medicine, Scott & White Clinic, Temple, Texas Geisinger Medical Center, Danville, Pennsylvania Exeter Hospital and Exeter Cardiovascular Associates, Exeter, New Hampshire Max Devki Devi Heart & Vascular Institute, Saket, New Delhi, India Yakima Heart Center, Yakima, Washington Royal Brompton Hospital, London, United Kingdom St. Vincent’s Hospital, Melbourne, Australia Maine Medical Center, Portland, Maine Sparks Health System, Fort Smith, Arkansas See Appendix Table