Guidelines for the Performance of Percutaneous Transluminal Coronary Angioplasty Prepared
نویسندگان
چکیده
PERCUTANEOUS transluminal coronary angioplasty (PTCA) is a new, innovative, nonoperative technique for treating selected patients with coronary artery disease.1 Data from the PTCA Registry of the National Heart, Lung, and Blood Institute indicate that PTCA can reduce the extent of coronary artery stenosis.2 Successful PTCA can relieve angina pectoris and improve objective signs of myocardial ischemia. In selected patients, these benefits can be obtained with a combined mortality and morbidity rate less than or similar to that associated with coronary artery bypass surgery.6,7 Although PTCA is performed in the cardiac catheterization laboratory with patients fully conscious and with techniques similar to those used in routine diagnostic catheterization and angiography, it is far more complex, requiring skills and knowledge beyond those necessary for usual diagnostic procedures. Serious complications, including death, have occurred as a result of PTCA, and the possibility of such complications is far greater than expected from diagnostic cardiac catheterization. The knowledge and experience gained by the developer and initial investigators of this technique and data contributed to the NHLBI Registry indicate that both the incidence of serious complications and of successful PTCA procedures may be related to patient selection and to performance characteristics and experience of the physician, the laboratory facility and the standby surgical team involved in the PTCA procedure.6 From an analysis of these data, we have formulated guidelines for the optimal performance of PTCA. These guidelines are intended for physicians, hospital administrators and health planners who contemplate the initiation of or continued performance of PTCA in an institution.
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