National Audit of Angioplasty Procedures - HQIP

This is the sixth written report of the United Kingdom’s National Audit of PercutaneousCoronary Interventional Procedures. The audit uses mechanisms developed incollaboration with the Central Audit Cardiac Database to collect procedure-specific databased on the current minimum British Cardiovascular Interventional Society (BCIS) dataset(www.bcis.org.uk). Annual audits from 1992 are available for download from the BCIS website, where a more detailed set of analyses relating to this report can also be found.The main objective of this audit is to help improve the care of patients who undergopercutaneous coronary interventional procedures in the UK. The audit allows clinicians toassess key aspects of the quality of their care when performing these procedures, andcompare their results with those from across the UK. The audit is led by the Audit Lead ofthe British Cardiovascular Intervention Society (BCIS) with participation from all hospitalsperforming PCI procedures. The data included in this report relates to proceduresperformed between 1st January and 31st December 2010.Aimed at healthcare professionals, medical directors, managers and clinical governanceleads, the report describes progress to date, key clinical findings and patient outcomes.Electronic copies of this report can be found at www.ucl.ac.uk/nicor/bcisFor further information about this report please contact d.marlee@ucl.ac.ukAcknowledgementsThe National Audit of Percutaneous Coronary Intervention has been developed and ledby the British Cardiovascular Intervention Society (BCIS) since 1988 and more recentlybeen managed by the National Institute for Cardiovascular Outcomes Research(NICOR). The analysis on which this report is based was undertaken by the BCIS AuditLead, Dr Peter Ludman, on behalf of BCIS.Peter F Ludman MA MD FRCP FESCConsultant Cardiologist,Queen Elizabeth Hospital,Birmingham, UKAudit Lead for the British Cardiovascular Intervention SocietyWe would like to acknowledge the important contribution of NHS Trusts and theindividual clinicians, nurses and audit teams who are participating in this audit.This audit was prepared in close collaboration with the Central Cardiac Audit Database(CCAD) team, who are now part of NICOR, and who performed the data management,Andy Donald (database and software developer) has been particularly involved.The National Audit of Percutaneous Coronary Intervention is commissioned and fundedby the Health Quality Improvement Partnership (HQIP) www.hqip.org.ukIMAGESFRONT COVER: ©Alain Pol; ISM/Science Photo LibraryFalse-colour arteriograph (angiograph) of the human heart, showing evidence of multiple stenosis (narrowing) in the left coronary artery (top right of heart on image).Unaffected blood vessels appear as continuous pink ribbons; the stenosed artery has a small diameter with a consequently reduced blood flow (ischaemia). Theobstruction is due to formation of fatty atheroma plaques on the arterial wall; the presence of a blood clot (thrombosis) in such an obstructed region would lead to thetotal blockage of the artery and subsequent death of the section of heart muscle it services - an event known as an acute myocardial infarction or heart attack.PAGE 23: ©Zephyr/Science Photo LibraryCoronary angioplasty. Coloured X-ray angiogram of a stent (orange) within and supporting a coronary artery of a heart. It was placed there during a coronaryangioplasty to treat stenosis (narrowing) of the artery. The flexible catheter used to place it and a balloon catheter (not seen), is seen running down from upper left.The inflation of the balloon catheter expanded the artery and restored normal blood flow. The stent was expanded by the balloon catheter and remains afterits withdrawal. Arterial stenosis may arise from arterial disease. X-ray angiography injects a radio-opaque contrast medium to highlight blood vessels on X-rays.This report may not be published or used commercially without permission.