Dawkins K D, Gershlick T, de Belder M, Chauhan A, Venn G, Schofield P, Smith D, Watkins J, Gray H H
British Cardiovascular Intervention Society, London, UK.
Heart. 2005 Dec;91 Suppl 6(Suppl 6):vi1-27. doi: 10.1136/hrt.2005.061457.
Cardiologists undertaking percutaneous coronary intervention (PCI) are excited by the combination of patient and physician satisfaction and technological advance occurring on the background of the necessary manual dexterity. Progress and applicability of percutaneous techniques since their inception in 1977 have been remarkable; a sound evidence base coupled with the enthusiasm and ingenuity of the medical device industry has resulted in a sea change in the treatment of coronary heart disease (CHD), which continues to evolve at breakneck speed. This is the third set of guidelines produced by the British Cardiovascular Intervention Society and the British Cardiac Society. Following the last set of guidelines published in 2000, we have seen PCI activity in the UK increase from 33,652 to 62,780 (87% in four years) such that the PCI to coronary artery bypass grafting ratio has increased to 2.5:1. The impact of drug eluting stents has been profound, and the Department of Health is investigating the feasibility of primary PCI for acute myocardial infarction. Nevertheless, the changes in the structure of National Health Service funding are likely to focus our attention on cost effective treatments and will require physician engagement and sensitive handling if we are to continue the rapid and appropriate growth in our chosen field. It is important with this burgeoning development now occurring on a broad front (in both regional centres and district general hospitals) that we maintain our vigilance on audit and outcome measures so that standards are maintained for both operators and institutions alike. This set of guidelines includes new sections on training, informed consent, and a core evidence base, which we hope you will find useful and informative.
进行经皮冠状动脉介入治疗（PCI）的心脏病专家，对患者满意度、医生满意度以及在必要的手工操作技能背景下出现的技术进步这三者的结合感到兴奋。自1977年经皮技术问世以来，其进展和适用性令人瞩目；坚实的证据基础，再加上医疗设备行业的热情与创造力，已使冠心病（CHD）的治疗发生了翻天覆地的变化，且这种变化仍在以惊人的速度持续发展。这是英国心血管介入学会和英国心脏学会制定的第三套指南。自2000年发布上一套指南以来，我们看到英国的PCI手术量从33,652例增加到了62,780例（四年内增长了87%），使得PCI与冠状动脉旁路移植术的比例增至2.5:1。药物洗脱支架的影响深远，卫生部正在研究急性心肌梗死进行直接PCI的可行性。然而，国民医疗服务体系资金结构的变化可能会使我们将注意力集中在具有成本效益的治疗方法上，并且如果我们要在所选领域继续实现快速且恰当的发展，就需要医生的参与以及谨慎的应对措施。鉴于目前在广泛领域（包括区域中心和地区综合医院）都出现了这种蓬勃发展的情况，我们必须对审核和结果指标保持警惕，以便为操作者和机构维持标准。这套指南包括关于培训、知情同意和核心证据基础的新章节，我们希望您会发现它们有用且信息丰富。
