A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, ...American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons Technical Panel Pamela S. Douglas, MD, MACC, FAHA, FASE, Moderator Manesh R. Patel, MD, FACC, Writing Group Liaison Steven R. Bailey, MD, FACC, FSCAI, FAHA, Writing Group Liaison Philip Altus, MD, MACPdaggerAmerican College of Physicians Representative Denise D. Barnard, MD, FACCdouble daggerHeart Failure Society of America Representative James C. Blankenship, MD, MACC, FSCAI* Donald E. Casey, Jr, MD, MPH, MBA, FACP, FAHAdagger Larry S. Dean, MD, FACC, FAHA, FSCAI* Reza Fazel, MD, MSc, FACC§American Society of Nuclear Cardiology Representative Ian C. Gilchrist, MD, FACC, FSCAI, FCCM||Society of Critical Care Medicine Representative Clifford J. Kavinsky, MD, PhD, FACC, FSCAI* Susan G. Lakoski, MD, MS¶American Heart Association Representative D. Elizabeth Le, MD, FACC, FASE#American Society of Echocardiography Representative John R. Lesser, MD, FACC, FSCAI, FSCCT**Society of Cardiovascular Computed Tomography Representative Glenn N. Levine, MD, FACC, FAHAdaggerdaggerSociety for Cardiovascular Magnetic Resonance Representative Roxana Mehran, MD, FACC, FACP, FCCP, FESC, FAHA, FSCAIdouble daggerdouble daggerAmerican College of Cardiology Foundation Representative Andrea M. Russo, MD, FACC, FHRS§§Heart Rhythm Society Representative Matthew J. Sorrentino, MD, FACCdouble daggerdouble dagger Mathew R. Williams, MD, FACC|||American Association for Thoracic Surgery/Society of Thoracic Surgeons Representative John B. Wong, MD, FACPdouble daggerdouble dagger Appropriate Use Criteria Task Force Michael J. Wolk, MD, MACC, Chair Steven R. Bailey, MD, FACC, FSCAI, FAHA Pamela S. Douglas, MD, MACC, FAHA, FASE Robert C. Hendel, MD, FACC, FAHA, FASNC Christopher M. Kramer, MD, FACC, FAHA James K. Min, MD, FACC Manesh R. Patel, MD, FACC Leslee Shaw, PhD, FACC, FASNC Raymond F. Stainback, MD, FACC, FASE Joseph M. Allen, MA Table of Contents Abstract... Preface In an effort to respond to the need for the rational use of cardiovascular services, including imaging and invasive procedures in the delivery of high-quality care, the American College of Cardiology Foundation (ACCF) in collaboration with other professional organizations has undertaken a process to determine the appropriate use of cardiovascular procedures for selected patient indications.
An organized and directed approach to a thorough review of evidence has resulted in the production of clinical practice guidelines that assist physicians in selecting the best management strategy for ...an individual patient. ...clinical practice guidelines can provide a foundation for other applications, such as performance measures, appropriate use criteria, and both quality improvement and clinical decision support tools. For certain conditions for which inadequate data are available, recommendations are based on expert consensus and clinical experience and are ranked as LOE C.\n ACS = acute coronary syndromes AKI = acute kidney injury BMS = bare-metal stent(s) CABG = coronary artery bypass graft surgery CAD = coronary artery disease CKD = chronic kidney disease CTO = chronic total occlusion DAPT = dual antiplatelet therapy DES = drug-eluting stent(s) ECG = electrocardiogram EF = ejection fraction EPD = embolic protection device FDA = U.S. Food and Drug Administration FFR = fractional flow reserve GDMT = guideline-directed medical therapy GI = gastrointestinal GP = glycoprotein IABP = intra-aortic balloon pump IV = intravenous IVUS = intravascular ultrasound LAD = left anterior descending LIMA = left internal mammary artery LV = left ventricular LVEF = left ventricular ejection fraction MACE = major adverse cardiac event MI = myocardial infarction MRI = magnetic resonance imaging NCDR = National Cardiovascular Data Registry PCI = percutaneous coronary intervention PPI = proton pump inhibitor RCT = randomized controlled trial SIHD = stable ischemic heart disease STEMI = ST-elevation myocardial infarction SVG = saphenous vein graft TIMI = Thrombolysis In Myocardial Infarction TMR = transmyocardial laser revascularization UA/NSTEMI = unstable angina/non-ST-elevation myocardial infarction UFH = unfractionated heparin * This table represents the relationships of reviewers with industry and other entities that were disclosed at the time of peer review and determined to be relevant.
Key Points
This article illustrates the positive impact of fluoroscopic imaging equipment on radiation dose reduction in CTO PCI.
The reader should recognize the importance of purchasing and ...maintaining the best equipment, understanding procedure/patient complexity, and assuring operator training in radiation dose reduction.
Future efforts/studies should focus upon all three areas of dose reduction for best results.
2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention Levine, Glenn N., MD, FACC, FAHA; Bates, Eric R., MD, FACC, FAHA; Blankenship, James C., MD, FACC, FSCAI ...
Journal of the American College of Cardiology,
12/2011, Volume:
58, Issue:
24
Journal Article
PDF
