January 31st, 2012
Appropriate Use Criteria for Revascularization Updated
Larry Husten, PHD
The ACC, AHA, and other organizations have released updated appropriate use criteria for coronary revascularization. The 2012 Appropriate Use Criteria for Coronary Revascularization Focused Update incorporates data from the SYNTAX trial on the indications for PCI and CABG in patients with symptomatic, multivessel disease, as well as data from the CathPCI registry.
Here are some of the key ratings:
- PCI for low-burden left main disease alone or with blockages in other arteries with a low disease burden: uncertain
- PCI for intermediate- or high-burden left main disease: inappropriate
- PCI for low-burden three-vessel disease: appropriate
- PCI for intermediate- or high-burden three-vessel disease: uncertain
- CABG remains appropriate for patients with two-vessel disease including the proximal LAD and three-vessel and left main disease.