SCAI Expert Consensus Statement on the Management of Patients With STEMI Referred for Primary PCI

Jacqueline E Tamis-Holland; J Dawn Abbott; Karim Al-Azizi; Nitin Barman; Anna E Bortnick; Mauricio G Cohen; Payam Dehghani; Timothy D Henry; Faisal Latif; Mohammad Madjid; Celina M Yong; Yader Sandoval

doi:10.1016/j.jscai.2024.102294

SCAI Expert Consensus Statement on the Management of Patients With STEMI Referred for Primary PCI

J Soc Cardiovasc Angiogr Interv. 2024 Oct 7;3(11):102294. doi: 10.1016/j.jscai.2024.102294. eCollection 2024 Nov.

Authors

Affiliations

¹ Cleveland Clinic Heart, Vascular & Thoracic Institute, Cleveland, Ohio.
² Lifespan Cardiovascular Institute, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
³ Baylor Scott & White The Heart Hospital - Plano, Plano, Texas.
⁴ Mount Sinai Morningside, New York, New York.
⁵ Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York.
⁶ Cleveland Clinic Florida, Weston, Florida.
⁷ University of Saskatchewan College of Medicine, Regina, Saskatchewan, Canada.
⁸ The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital, Cincinnati, Ohio.
⁹ SSM Health St. Anthony Hospital and University of Oklahoma, Oklahoma City, Oklahoma.
¹⁰ David Geffen School of Medicine at UCLA, Los Angeles, California.
¹¹ Stanford University School of Medicine, Stanford, California.
¹² Palo Alto Veterans Affairs Healthcare System, Palo Alto, California.
¹³ Minneapolis Heart Institute, Abbott Northwestern Hospital, and Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota.

Abstract

ST-elevation myocardial infarction (STEMI) remains a leading cause of morbidity and mortality in the United States. Timely reperfusion with primary percutaneous coronary intervention is associated with improved outcomes. The Society for Cardiovascular Angiography & Interventions puts forth this expert consensus document regarding best practices for cardiac catheterization laboratory team readiness, arterial access with an algorithm to help determine proper arterial access in STEMI, and diagnostic angiography. This consensus statement highlights the strengths and limitations of various diagnostic and therapeutic interventions to access and treat a patient with STEMI in the catheterization laboratory, reviews different options to manage large thrombus burden during STEMI, and reviews the management of STEMI across the spectrum of various anatomical and clinical circumstances.

Keywords: PCI; STEMI; intravascular imaging; mechanical circulatory support; microvascular obstruction; no reflow.