title: Percutaneous coronary intervention without onsite cardiac surgery backup.
abstract: BACKGROUND
  Mechanical revascularization by percutaneous coronary interventions has now become an established and preferable method of revascularization in patients with acute coronary syndromes. The aim of the study was to identify the clinical indications for percutaneous coronary interventions and in-hospital outcomes of percutaneous coronary interventions in a tertiary-level hospital without onsite cardiac surgery backup.
  
  
  METHODS
  This was a prospective descriptive study. All consecutive patients who were admitted for percutaneous coronary interventions, including both primary as well as elective percutaneous coronary interventions, between March 2011 and December 2012 were included in the study.
  
  
  RESULTS
  Total 101 percutaneous coronary interventions were performed. The mean age was 58.9 ± 12.3 years. The most frequent indication was ST-elevation myocardial infarction 72 (71.3%). Proximal artery stenting were performed in 39 (38.5%) and the non proximal artery stenting in 62 (61.5%). The outcomes were mortality 5 (4.9%), periprocedural myocardial infarction 2 (1.9%), cardiogenic shock 6 (5.9%), contrast induced nephropathy requiring dialysis in 3 (2.9%), minor complications which were managed conservatively in 13 (12.9%).
  
  
  CONCLUSIONS
  Percutaneous coronary intervention was feasible with acceptable complications in a tertiary-level hospital without onsite cardiac surgery backup. ST-elevation myocardial infarction was the major indication and cardiogenic shock was the major complication observed, and non proximal artery stenting was more common than the proximal artery stenting.
authors.affiliation: Department of Cardiology, College of Medical Sciences and Teaching Hospital, Bharatpur-10, Chitwan, Nepal.
authors.forename: Laxman
authors.initials: L
authors.lastname: Dubey
authors.forename: Sanjib Kumar
authors.initials: SK
authors.lastname: Sharma
authors.forename: Rabindra
authors.initials: R
authors.lastname: Bhattacharya
authors.forename: Sogunuru
authors.initials: S
authors.lastname: Guruprasad
authors.forename: Gangapatnam
authors.initials: G
authors.lastname: Subramanyam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D003287:Contrast Media / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D009390:Nepal; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011446:Prospective Studies; D012008:Recurrence; D012770:Shock, Cardiogenic / Q000453:epidemiology; D015607:Stents; D020521:Stroke / Q000453:epidemiology; D063128:Tertiary Health Care; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: indication, onsite cardiac surgery, outcomes, percutaneous coronary interventions.