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Surgical Turned-Downed CHIP Cases—Can PCI Save the Day?
Current guidelines, rarely if at all, address decision-making for revascularization when bypass surgery is not a possibility for high-risk cases. Patients who are surgically turned down are routinely excluded from clinical trials, even though they remain symptomatic. Furthermore, the reasons for sur...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021524/ https://www.ncbi.nlm.nih.gov/pubmed/35463754 http://dx.doi.org/10.3389/fcvm.2022.872398 |
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author | Achim, Alexandru Marc, Madalin Ruzsa, Zoltan |
author_facet | Achim, Alexandru Marc, Madalin Ruzsa, Zoltan |
author_sort | Achim, Alexandru |
collection | PubMed |
description | Current guidelines, rarely if at all, address decision-making for revascularization when bypass surgery is not a possibility for high-risk cases. Patients who are surgically turned down are routinely excluded from clinical trials, even though they remain symptomatic. Furthermore, the reasons for surgical ineligibility are often times not captured in standardized risk models. There is no data regarding health status outcomes following PCI procedures in these patients and the ultimate question remains whether the benefits of PCI outweigh its risks in this controversial subpopulation. When CHIP (Complex High risk Indicated Percutaneous coronary interventions) is selected for these very complex individuals, there is no unanimity regarding the goals for interventional revascularization (for instance, the ambition to achieve completeness of revascularization vs. more targeted or selective PCI). The recognition that, worldwide, these patients are becoming increasingly prevalent and increasingly commonplace in the cardiac catheterization labs, along with the momentum for more complex interventional procedures and expanding skillsets, gives us a timely opportunity to better examine the outcomes for these patients and inform clinical decision-making. |
format | Online Article Text |
id | pubmed-9021524 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90215242022-04-22 Surgical Turned-Downed CHIP Cases—Can PCI Save the Day? Achim, Alexandru Marc, Madalin Ruzsa, Zoltan Front Cardiovasc Med Cardiovascular Medicine Current guidelines, rarely if at all, address decision-making for revascularization when bypass surgery is not a possibility for high-risk cases. Patients who are surgically turned down are routinely excluded from clinical trials, even though they remain symptomatic. Furthermore, the reasons for surgical ineligibility are often times not captured in standardized risk models. There is no data regarding health status outcomes following PCI procedures in these patients and the ultimate question remains whether the benefits of PCI outweigh its risks in this controversial subpopulation. When CHIP (Complex High risk Indicated Percutaneous coronary interventions) is selected for these very complex individuals, there is no unanimity regarding the goals for interventional revascularization (for instance, the ambition to achieve completeness of revascularization vs. more targeted or selective PCI). The recognition that, worldwide, these patients are becoming increasingly prevalent and increasingly commonplace in the cardiac catheterization labs, along with the momentum for more complex interventional procedures and expanding skillsets, gives us a timely opportunity to better examine the outcomes for these patients and inform clinical decision-making. Frontiers Media S.A. 2022-04-07 /pmc/articles/PMC9021524/ /pubmed/35463754 http://dx.doi.org/10.3389/fcvm.2022.872398 Text en Copyright © 2022 Achim, Marc and Ruzsa. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Achim, Alexandru Marc, Madalin Ruzsa, Zoltan Surgical Turned-Downed CHIP Cases—Can PCI Save the Day? |
title | Surgical Turned-Downed CHIP Cases—Can PCI Save the Day? |
title_full | Surgical Turned-Downed CHIP Cases—Can PCI Save the Day? |
title_fullStr | Surgical Turned-Downed CHIP Cases—Can PCI Save the Day? |
title_full_unstemmed | Surgical Turned-Downed CHIP Cases—Can PCI Save the Day? |
title_short | Surgical Turned-Downed CHIP Cases—Can PCI Save the Day? |
title_sort | surgical turned-downed chip cases—can pci save the day? |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9021524/ https://www.ncbi.nlm.nih.gov/pubmed/35463754 http://dx.doi.org/10.3389/fcvm.2022.872398 |
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