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PCI Models: Gloucestershire

PCI Models: Gloucestershire. Nick West Consultant Cardiologist. MY CONFLICTS OF INTEREST ARE:. Advisory Board: Nycomed, Astrazeneca, Schering-Plough Speaker Fees: Nycomed, Astrazeneca, Schering Plough, MSD Sponsorship: Boston Scientific, Nycomed, Medtronic, Abbott Vascular

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PCI Models: Gloucestershire

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  1. PCI Models: Gloucestershire Nick West Consultant Cardiologist

  2. MY CONFLICTS OF INTEREST ARE: Advisory Board: Nycomed, Astrazeneca, Schering-Plough Speaker Fees: Nycomed, Astrazeneca, Schering Plough, MSD Sponsorship: Boston Scientific, Nycomed, Medtronic, Abbott Vascular Research Grants: Bristol-Myers Squibb

  3. Glos Hosps NHS Foundation Trust • 650,000 population • 2 DGHs • 2 Cath labs • 3 Interventionalists • Remote from Tertiary centres

  4. A local service Who should go to a surgical centre? • Viewpoints: • Patients • Trusts • Cardiologists

  5. PCI in Gloucestershire:Inpatient vs. Elective work. Cases/year (n)

  6. Possible issues • Out-of-hours/on-call • Specialist techniques/devices • ‘High risk’ cases • Research studies

  7. Out of hours/on-call • Can your service offer PCI 24/7? • Are you geared up for emergencies? • How many interventionalists are there? • Is there an on-call rota? • Do the rest of the cath lab staff want this? • Is it cost-effective? • Network solutions

  8. What is ‘high risk’?

  9. PCI in Gloucestershire:Inpatient vs. Elective work. Cases/year (n)

  10. How do we measure up? Grayson et al. Heart 2006; 92: 658-663 Inhospital MACE (%)

  11. Research Studies • Should offsite centres be allowed to join in?

  12. Noninflammatory responseand rapid endothelialization* • Rapid and complete drug delivery • Highly lipophillic limus analogue • PC Biomimetic polymer • Reduced platelet deposition E-5 Registry: the ‘Real World’ • Final UK recruitment: Cheltenham General 100 Leeds General 65 Royal Victoria, Belfast 51 St. Georges, London 46 James Cook, M’boro 36 QE, Birmingham 35 Derriford, Plymouth 18 Barts, London 14 Nottingham City 13 Walsgrave, Coventry 13 London Chest 12

  13. Possible issues • Out-of-hours/on-call • Specialist techniques/devices • ‘High risk’ cases • Research studies ? X X X

  14. Summary • Few good arguments to limit offsite work • Can we all live together happily ever after? Acknowledgements Rafe Chamberlain-Webber Zafar Khan All cath lab staff at CGH

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