Abubakar Muhammad, Javed Izzah, Rasool Hafiz Fahad, Raza Saud, Basavaraju Deepak, Abdullah Rai Muhammad, Ahmed Faizan, Salim Siffat S, Faraz Muhammad Ahmad, Hassan Khawaja Mushammar, Hajjaj Mohsin
Department of Internal Medicine, Ameer-ud-Din Medical College/Lahore General Hospital, Lahore, PAK.
Department of Internal Medicine, Siddique Sadiq Memorial Trust Hospital, Gujranwala, PAK.
Cureus. 2023 Jul 3;15(7):e41311. doi: 10.7759/cureus.41311. eCollection 2023 Jul.
Percutaneous coronary intervention (PCI) is a widely used therapy for coronary artery disease (CAD), but it carries risks and complications. Adhering to evidence-based practice guidelines is crucial for optimal outcomes. This review compares the recommendations of the 2021 American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions (ACC/AHA/SCAI) and 2018 European Society of Cardiology (ESC) guidelines for coronary artery revascularization and discusses emerging trends and novel devices in PCI. A comprehensive literature review of mixed studies, clinical trials, and guidelines was conducted. Intravascular imaging, including intravascular ultrasound and optical coherence tomography, for stent optimization, is also recommended when feasible. However, differences reflecting variations in evidence quality interpretation and applicability were identified. Furthermore, novel devices and technologies with the potential for improving outcomes were highlighted, but their safety and efficacy compared to standard-of-care techniques require further evaluation through extensive randomized trials. Clinicians should stay updated on advancements and personalize treatment decisions based on individual patient factors. Future research should address evidence gaps and barriers to adopting innovative devices and techniques. This review provides recommendations for clinical practice, emphasizing the need to remain current with the evolving landscape of PCI to optimize patient outcomes. The discoveries provide valuable counsel for the deliberation of clinical interventions and prospective inquiries within the realm of interventional cardiology. Overall, the review underscores the importance of evidence-based practice and ongoing advancements in PCI for CAD management.
经皮冠状动脉介入治疗(PCI)是治疗冠状动脉疾病(CAD)广泛应用的一种疗法,但它存在风险和并发症。遵循循证实践指南对于取得最佳治疗效果至关重要。本综述比较了2021年美国心脏病学会/美国心脏协会/心血管造影和介入学会(ACC/AHA/SCAI)与2018年欧洲心脏病学会(ESC)关于冠状动脉血运重建指南的建议,并讨论了PCI领域的新趋势和新型器械。对混合研究、临床试验和指南进行了全面的文献综述。在可行的情况下,还建议使用血管内成像,包括血管内超声和光学相干断层扫描,以优化支架植入。然而,发现了在证据质量解释和适用性方面存在差异。此外,强调了具有改善治疗效果潜力的新型器械和技术,但其与标准治疗技术相比的安全性和有效性需要通过广泛的随机试验进行进一步评估。临床医生应及时了解进展情况,并根据患者个体因素进行个性化治疗决策。未来的研究应解决证据空白以及采用创新器械和技术的障碍。本综述为临床实践提供了建议,强调需要紧跟PCI不断发展的形势,以优化患者治疗效果。这些发现为介入心脏病学领域的临床干预和前瞻性研究提供了有价值的参考。总体而言,该综述强调了循证实践以及PCI在CAD管理方面持续进展的重要性。