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May 14, 2020

SCAI Position Statement Addresses Optimal PCI Therapy for Complex CAD

May 14, 2020—The Society for Cardiovascular Angiography and Interventions (SCAI) announced the publication of an official position statement on optimal percutaneous coronary intervention (PCI) treatment of patients with complex coronary artery disease (CAD). The document by Robert F. Riley, MD, et al is available online ahead of print in Catheterization & Cardiovascular Interventions. The position statement was presented during the SCAI 2020 scientific sessions virtual conference held online May 14–16.

In the position statement, a multidisciplinary group of experts shares a state-of-the-art update addressing evidence regarding PCI in patients with complex clinical and anatomic features and provides procedural guidance to achieve optimal outcomes for this challenging patient group. The document examines preprocedural assessment of coronary anatomic complexity and higher-risk clinical features and interventional treatment of complex CAD.

According to SCAI, the procedural complexity of PCI and the risk of adverse patient outcomes is increased by both complex anatomic lesions and clinical parameters including advanced age, frailty, comorbidities, compromised hemodynamic status, depressed ventricular function, and concomitant valvular disease.

In the SCAI announcement, Dr. Riley commented, “Over the last several years, there has been an increase in the anatomic and physiologic complexity of patients presenting to the catheterization lab. During that time, a multitude of tools have been developed to aid defining and treating this group when percutaneous revascularization is indicated. However, this population has been incompletely defined up to this point, and there is a need to provide a contemporary evidence-based document that specifically addresses aspects of complex PCI in this patient group.”

He continued, “This document further complements the concomitantly published SCAI statement on the performance of PCI in ambulatory surgical centers. Together, we hope these documents will provide guidance on best practices and the performance settings for PCI across the spectrum of clinical and anatomical complexity.” Dr. Riley is Research and Medical Director of the Complex Coronary Therapeutics Program at The Christ Hospital in Cincinnati, Ohio.

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