Coronary stenting is the most commonly used method of myocardial revascularization, with approximately 2 million stents implanted in 2004 throughout the world. The development of drug eluting stents have resulted in very low rates of repeat intervention and will further increase the scope for percutaneous coronary intervention.
The evidence from large randomized trials is generally accepted to be the gold standard source of information for patient care in interventional cardiology. However, it is well recognized that information from these trials is frequently insufficient to guide the wide-ranging clinical situations found in routine practice. In this context, decision-making is often based on a composite of information from multiple clinical studies, pathophysiological considerations and importantly, personal experience or ‘gut-feeling’..
Examples of common clinical dilemmas include:
- the optimal timing for non cardiac major surgery after coronary stent implantation,
- the best treatment strategy(ies) for patients with diffuse obstructive atherosclerotic disease (coronary, carotid and aortic)
- different strategies for non-elective surgical treatment for patients on potent anti-platelet agents.
- the management of patients with past history of severe allergic reactions, patients with renal impairment, etc.
- indications for coronary diagnostic angiography followed by subsequent angioplasty at the same procedure (ad-hoc angioplasty),
This book, written by internationally recognized experts in their field, provides clear and concise recommendations regarding various challenging clinical situations facing the interventional cardiologist on a daily basis.