You could learn more about cardiology courses with Prof. Sameh Allam by clicking on the courses’ library link here:

Objectives for this course:
1- Master the essentials of a successful complex PCI by using the radial approach
2- Essential questions on radial approach and the use of the specific radial device(s)
3- Clinical case strategy and radial approach limits
4- Anatomical variations in the Radial artery.
5- Master the essential steps of a successful radial procedure.

Percutaneous Coronary Intervention (PCI, formerly known as angioplasty with stent) is a non-surgical procedure that uses a catheter (a thin flexible tube) to place a small structure called a stent to open up blood vessels in the heart that have been narrowed by plaque buildup, a condition known as atherosclerosis.

In other words, percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a non-surgical procedure that improves blood flow to your heart. PCI requires cardiac catheterization, which is the insertion of a catheter tube and injection of contrast dye, usually iodine-based, into your coronary arteries.

In this lecture, professor Sameh Allam discusses that “Does percutaneous coronary intervention (PCI) reduce mortality among patients with stable coronary artery disease?”

Very few questions have been so hotly debated within the medical literature over the past decade. Invasive treatment with PCI has figured prominently in the treatment of patients with coronary artery disease, with 1.3 million PCIs performed in the United States in 2005.

The rapid growth in PCI as a viable alternative to medical therapy or coronary artery bypass graft (CABG) surgery was catalyzed initially by the esthetic appeal of this less invasive procedure to improve flow in the coronary arteries and was subsequently reinforced by the improved ease and safety of PCI. Proponents of PCI argue that improved blood flow leads to reduced ischemic substrate and improved overall prognosis, whereas opponents claim that patients with stable coronary artery disease have coronary plaques that are less likely to result in an acute coronary syndrome. Therefore, intervening focally on a coronary lesion via PCI is unlikely to alter their overall prognosis.

This conclusion has been supported by earlier meta-analyses and by the recently published Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation study, the largest trial to date to address whether PCI is beneficial as compared with medical therapy among patients with stable coronary artery disease
These studies consistently indicated no risk reduction in the incidence of myocardial infarction or death associated with PCI.

Through many studies, we could say that Percutaneous coronary intervention (PCI) reduces mortality in most myocardial infarction (MI) patients but the effect on elderly patients with comorbidities is unclear. Our aim was to analyze the effect of PCI on in-hospital mortality of MI patients, by age, sex, ST elevation on presentation, diabetes mellitus (DM), and chronic kidney disease (CKD).

Despite improvements in door-to-balloon time, no parallel reductions in mortality rate and total ischemic time were observed. Total ischemic time was associated with mortality. The present study suggests that additional efforts are needed to shorten total ischemic time including patient and pre-hospital systemic delay for better prognosis after primary PCI.

Finally, we could conclude that PCI decreased in-hospital mortality in MI patients regardless of age, sex, and presence of ST elevation, DM, and CKD. This supports the recommendation for PCI in elderly patients with DM or CKD.

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