SCAI Expert Consensus Statement on Percutaneous Coronary Intervention Without On-Site Surgical Backup
Bibliographic record
Abstract
• Elective PCI in settings without SOS has increased in volume and complexity (extending beyond the simple lesion recommendations in the 2014 document). In addition, PCI is now being performed outside the hospital setting, in OBLs and ASCs. • Several new studies in the United States and abroad have demonstrated that PCIs performed at non-SOS centers have very low rates of complications and similar outcomes to PCIs performed at surgical centers. • Despite increases in age, comorbidities, and lesion complexity, the rate of periprocedural complications has remained constant, or declined, with rates of emergency surgery as low as 0.1% in many series. • Complex PCI, including unprotected left main, is being performed at some non-SOS centers, with no increase in MACE or emergency CABG surgery compared with PCI at surgical centers. There have been no comparative studies in other complex PCI subgroups, such as CTO and atherectomy, but observational studies demonstrate reasonable outcomes and suggest feasibility with experienced interventional cardiologists. • The authors propose a new PCI treatment algorithm ( Figure 1 ) that expands the type of cases that can be performed without SOS compared with the 2014 document, with consideration of patients’ clinical and lesion risk, operator experience (both recent and accumulated), and the experience and rescue capabilities of the site. • In the United States, there are considerable financial savings (to insurers and Medicare) for PCI to be performed at ASCs and OBLs, so out-migration of procedures from hospitals should be anticipated.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.038 | 0.073 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.009 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.007 | 0.003 |
| Open science | 0.008 | 0.004 |
| Research integrity | 0.019 | 0.017 |
| Insufficient payload (model declined to judge) | 0.013 | 0.012 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".