SCAI Issues Report on Multivessel PCI Treatment

November 9, 2011—The Society for Cardiovascular Angiography and Interventions (SCAI) announced that the first comprehensive report to review the timing of treatment for patients with blockages in more than one coronary artery recommends a flexible approach that meets individual patient's needs. James C. Blankenship, MD, et al published the report online ahead of print in SCAI's journal, Catheterization and Cardiovascular Interventions.



According to SCAI, up to half of all patients with coronary artery disease have blockages in more than one artery and as many as one in five percutaneous coronary intervention (PCI) patients receive treatment in more than one vessel. The society's new clinical document reviews treatment options for these patients and provides recommendations for treatment of multiple vessels in one stage or in multiple stages. 



“When multiple arteries are treated, it is usually done in one session, which may not be the safest approach,” commented Dr. Blankenship. “Yet, interventional cardiologists have not had comprehensive recommendations on when it is better to split the treatment of several arteries into two sessions. Splitting the procedure into separate sessions is less convenient for patients and more costly to insurers. Thus, cardiologists may feel pressured into doing too much in one session. That can be dangerous for some patients. With this document, SCAI provides guidance for treating these patients and ensuring every step of the procedure is as safe as possible and appropriate for each patient's individual health condition.”

SCAI advised that the report makes several recommendations for treating multivessel coronary artery disease patients, including: giving all PCI patients the best medical therapy, ideally starting before PCI; treating multiple vessels during diagnostic procedures only if the patient knows the risks and benefits; starting the procedure with a strategy for which blockages to treat and which to treat first to get the best outcomes; changing the treatment strategy midprocedure if the patient's condition changes; and reevaluating the need for additional treatment at each stage of the procedure.

Dr. Blankenship concluded, “Recent research studies have changed our understanding of which patients are best treated with medications, bypass surgery, or coronary artery stenting. We have to translate these scientific studies into guidelines that help doctors treat their patients. This report will help interventional cardiologists provide the best treatment to improve each patient's health.”