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ESC Congress 2003: ESC Guidelines for Percutaneous Coronary Interventions (PCI)

September 03, 2003

IMPORTANT: This press release accompanies a presentation given at the ESC Congress 2003.
Written by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology

Background:
The non-surgical treatment of severely narrowed coronary arteries (stenosis) has grown tremendously over the last years with now over 1 million procedures world-wide. These procedures are performed through a little skin incision in the groin (â€žpercutaneous") to avoid open heart surgery.

In contrast to the early days of PCI, where only â€žplain" balloons were available, there is an increasing number of various additional devices, methods and medications creating the need for European guidelines. Although there were several reports regarding PCIs in Europe published previously, the ESC now presents guidelines regarding this topic for the first time.

The form of the guidelines will rather be a table format with additional text rather than a textbook. The guidelines will not discuss the questions of plain balloon vs. stenting (with the regular stainless steel stent) and will also not debate comparisons of different stainless steel bare stents and necessary cath-lab-equipments.

Methods:
Publications were screened by Medline search and judged by an expert committee of 12 members. Since there is almost no field in medicine with such fast moving targets and major pivotal studies, oral presentations at late breaking sessions at major symposia were also included.

In accordance with the ESC rules, the recommendations were classified according level of evidence (A, B or C) and according to class I or class II. The traditional class III (not indicated or possibly harmful) was not used.

Topics:
Following topics will be discussed within their levels of recommendation:
"��Acute coronary syndrome (ACS) with ST-elevation, esp. recommendations for primary PCI under various circumstances. ACS without ST-elevation: recommendations as above
"��Stable coronary artery disease: recommendations for standard PCI in patients with stable angina or objective ischemia
"��Specific subsets of patients with coronary artery disease (diabetics, unprotected left main, high surgical risk, saphenous vein grafts)

The next chapter will describe the usefulness of special devices like rotablation, direct coronary atherectomy, cutting-balloons, brachytherapy and the rapidly growing field of drug eluting stents. The recommendations for distal protection devices will also be presented. In addition, the levels of evidence for adjunctive medications like clopidogrel or glycoprotein IIb/IIIa-inhibitors will be evaluated.

Prof. Dr. Sigmund Silber, Munich
Germany
Chairman

European Society of Cardiology (ESC)

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