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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...

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Detalles Bibliográficos
Autores principales: Achim, Alexandru, Marc, Madalin, Ruzsa, Zoltan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
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.
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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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