Urgent coronary bypass surgery for failed percutaneous coronary intervention in the stent era: Is backup still necessary?

Abstract

Background Current practice guidelines for performance of percutaneous coronary intervention (PCI) in the United States mandate availability of on-site surgical backup. With the decreasing frequency of urgent coronary bypass surgery (UCABG) with newer technologies, it is unclear whether such backup continues to be necessary. Methods A database of 5655 consecutive patients undergoing PCI at a single center between August 1, 1992, and December 31, 1997, was analyzed. Outcomes were determined as well as clinical, lesion, and procedural characteristics of patients during 4 time periods preceding and during use of coronary stenting. Results Frequency of UCABG for failed PCI decreased from 2.2% to 0.6% in the most recent time period (P