Unprotected percutaneous coronary intervention is safe and effective for treating unstable angina in the modern warrior: the second Gulf War experience at Landstuhl Regional Medical Center, Germany.
BACKGROUND
Evacuation of soldiers with acute coronary syndromes to U.S. hospitals has been the treatment strategy of choice. However, percutaneous coronary intervention (PCI) complication rates have decreased to the point that it is feasible to bring this therapy forward.


METHODS
Patients presenting with acute coronary syndromes during Operation Iraqi Freedom (March 2003 to June 2003] were evacuated to Landstuhl Regional Medical Center, Germany. Patients with a high clinical risk but a low interventional risk were selected for unprotected PCI.


RESULTS
PCI was successfully accomplished for 93% of patients (13 of 14 patients). One patient had a 1-month history of progressive angina and a chronic total lesion that could not be crossed. There were no major complications.


CONCLUSIONS
Patients with acute coronary syndromes who are risk-stratified can be safely treated with PCI at overseas military hospitals lacking cardiothoracic surgical back-up assistance. This strategy minimizes the risk of transoceanic evacuation of this patient population.
Filardo
Steven
S
Wright-Patterson Medical Center, Wright-Patterson AFB, OH 45433, USA.
Mata
Reuben
R
Willingham
Cathy
C
Coyle
Louis
L
Older
Steven
S
Torrent
John
J
Modlin
Randolph
R
D017732:Air Ambulances; D000789:Angina, Unstable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000592:standards*; D005260:Female; D005858:Germany; D006772:Hospitals, Military; D006801:Humans; D007493:Iraq; D008297:Male; D008875:Middle Aged; D008887:Military Medicine / Q000592:standards*; D008889:Military Personnel; D018570:Risk Assessment; D012449:Safety; D014481:United States