Related Experiment Video
Updated: Jan 21, 2026
Novel Percutaneous Approach for Deployment of 3D Printed Coronary Stenosis Implants in Swine Models of Ischemic Heart Disease
Published on: February 18, 2020
Percutaneous coronary interventions for stable ischemic heart disease in Italy
Stefano De Servi1, Zoran Olivari2, Gabriele Crimi3
1Unita' di Cardiologia, IRCCS MultiMedica, Milan.
Insights
Percutaneous coronary interventions (PCIs) for stable chronic ischemic heart disease (SIHD) are common in Italy, with significant regional differences. Increased use of fractional flow reserve (FFR) and Heart Team assessments correlate with fewer ad-hoc PCIs.
Area of Science:
- Cardiology
- Interventional Cardiology
- Public Health
Background:
- Percutaneous coronary interventions (PCIs) for stable chronic ischemic heart disease (SIHD) are frequently performed, often without physiologic guidance like fractional flow reserve (FFR).
- The benefits of PCI in SIHD remain controversial, yet utilization is high.
- Significant regional variations in PCI practices exist within Italy.
Purpose of the Study:
- To assess regional variations in PCI for SIHD in Italy.
- To investigate the correlation between PCI rates and the utilization of FFR.
- To evaluate the impact of mandated Heart Team assessments on ad-hoc PCI procedures.
Main Methods:
- Analysis of the Italian Society of Interventional Cardiology (SICI-GISE) registry data for 2017.
- Correlation of regional PCI per million inhabitants with FFR usage.
- Comparison of ad-hoc PCI rates in regions with and without mandated Heart Team reviews.
Main Results:
- PCI for SIHD constituted 44.5% of all PCIs in Italy, with substantial regional disparities.
- A significant inverse relationship was observed between FFR use and the number of SIHD PCIs per capita (P=0.01).
- The Veneto region, with mandated Heart Team assessments, showed a lower rate of ad-hoc procedures than the national average.
Conclusions:
- PCI for SIHD represents a significant proportion of procedures in Italy, exhibiting regional variability linked to the use of physiologic guidance.
- Mandatory Heart Team evaluation for multivessel disease patients is associated with a reduction in ad-hoc PCI procedures.
- These findings highlight the importance of structured decision-making processes and physiologic guidance in optimizing PCI utilization for SIHD.
Aims:
Although the benefits of percutaneous coronary interventions (PCIs) in patients with stable chronic ischemic heart disease (SIHD) are controversial, a large number of PCIs are currently performed in SIHD patients, frequently after coronary angiography (ad-hoc procedures), without the use of fractional flow reserve (FFR) to identify patients most likely to benefit from PCI.
Methods:
Assessment of regional variations in PCI for SIHD performed in Italy in 2017 and correlation of the regional number of PCI per million inhabitants with the use of FFR were performed using the data reported in the registry of the Italian Society of Interventional Cardiology (SICI-GISE) registry for the year 2017.
Results:
PCI for SIHD accounted for 44.5% of all PCI performed in Italy with large variations among the Italian regions. There was a significant and inverse relationship between the use of FFR and the PCI number per million inhabitants performed for SIHD in the various Italian regions (P = 0.01). In the Veneto region, where local authorities mandated Heart Team reports to select the most appropriate treatment choice in multivessel disease patients, the rate of ad-hoc procedures was significantly lower than the national average.
Conclusion:
PCI for SIHD patients represent almost half of all procedures currently performed in Italy with regional variations inversely related to physiologic guidance use. The mandatory assessment by the Heart Team to select the most appropriate treatment choice in multivessel disease patients is associated with a significantly lower number of ad-hoc procedures.
Related Concept Videos
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:30Coronary Artery Disease I: Introduction
01:30Heart Failure VII: Nursing Interventions
01:26Coronary Artery Disease II: Pathophysiology
01:27Coronary Artery Disease V: Interprofessional Care
01:23Rheumatic Heart Disease I: Introduction