In the early days of percutaneous intervention – stenting and so on – you’d always want to have cardiothoracics around to crack the chest in case of emergency bypass surgery. As the population gets larger, and further away from major centres, more places are doing diagnostic angiography, and some of them are starting to stent. This month’s NEJM has a look at the safety of doing PCI without surgical backup.
Looking at over 18,000 cases, they found that 6 week mortality was about the same (0.9% vs 1%), and 9 month mortality was not inferior – and interestingly, target vessel revascularisation rates were higher in the group with PCI only.
This is going to be a big area, and it’s interesting in a large country like Australia where a PCI centre could be hundreds of kilometres away from a major surgical centre.
image | John Crel
source | NEJM