Does the “ Non -IRA ” lesion status confuse you often ?..Try a blind primary PCI !

Primary PCI of IRA , continues to be a clinically & statisticaly validated  (Inspite of some ifs & buts) coronary reperfusion strategy. What to do, if  we happen to detect, a significant or borderline lesion in non- IRA territory ? There are too many guidelines scattered across cardiology literature either to “help or confuse” us. They argue for either immediate intervention , defer transiently, postpone or just ignore it , based on clinical ,hemodynamic*, Individual, institutional , or some other non academic factors. (Permanently deferred PCI is other wise called medical management is practiced by some GPs who never refer such patients to higher centers after a stand alone thrombolysis) * The FFR, iFR RFR, related stuff What if if we are completely blinded to the status of Non IRA vessel ? What do mean ? I mean , can we be, “not- aware” of contra-lateral lesion status ? Yes, “Simply don’t do a non IRA angiogram , that’s it. If its RCA PCI , don’t shoot Left main, and vice versa for LAD. Do a PCI without doing a completed CAG. I mean IRA PCI alone, by guessing it by ECG . What a crazy Idea ? This week’s JAMA has something* remotely relatable to this idea. The aim was to do PCI before complete CAG , to document any advantage. (It is important to note, CAG was done in all patients) Click to access levi_2024_oi_240163_1711065732.05999.pdf Did this study really happen ...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized Source Type: blogs