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Sirolimus-eluting stent implantation for unprotected left main coronary artery stenosis: comparison with bare metal stent implantation Impact of chronic obstructive pulmonary disease on prognosis after percutaneous coronary intervention and bypass surgery for left main coronary artery disease: an analysis from the EXCEL trial Percutaneous coronary intervention for the left main stem and other bifurcation lesions: 12th consensus document from the European Bifurcation Club Long-Term Clinical Outcomes and Optimal Stent Strategy in Left Main Coronary Bifurcation Stenting C-reactive protein and prognosis after percutaneous coronary intervention and bypass graft surgery for left main coronary artery disease: Analysis from the EXCEL trial Restricted access Mortality After Repeat Revascularization Following PCI or CABG for Left Main Disease: The EXCEL Trial Left main coronary angioplasty: early and late results of 127 acute and elective procedures Impact of large periprocedural myocardial infarction on mortality after percutaneous coronary intervention and coronary artery bypass grafting for left main disease: an analysis from the EXCEL trial Self-expandable sirolimus-eluting stents compared to second-generation drug-eluting stents for the treatment of the left main: A propensity score analysis from the SPARTA and the FAILS-2 registries Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents

Editorial2018 Oct 1;92(4):651-652.

JOURNAL:Catheter Cardiovasc Interv. Article Link

Volume brings value

Gogas BD, Chen SL.

ABSTRACT


  • What the article teaches

    The article highlights the competency of high volume operators across institutions that despite moving to lower volume centers retain their good clinical outcomes.


  • How it will impact practice

  • Although current U.S. based guidelines suggest a volume of at least 50 PCIs annually for operators to retain clinical competency this estimate may be a poor index to guarantee optimal clinical outcomes.


  • What new research/study would help answer the question

    New studies using a comprehensive definition to define an experienced operator from the Asia‐Pacific—a geographic area that has pioneered in complex coronary interventions—need to elute on the threshold of adequate clinical competency stratified according to clinical complexity.