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Coronary angioplasty: guidelines for good practice and training
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  1. Joint Working Group on Coronary Angioplasty of the British Cardiac Society British Cardiovascular Intervention Society
  1. Dr H H Gray, Wessex Cardiac Unit, Southampton University Hospitals, Southampton SO16 6YD, UK

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Procedures involving the use of balloon dilatation catheters, stents, and other percutaneously delivered interventional devices are now commonly performed on selected patients with coronary heart disease (CHD). It is axiomatic that centres undertaking such procedures must be properly equipped and staffed, their operators competent, and the cases selected appropriate. Patients advised to undergo a coronary intervention procedure should have received sound professional advice, and their procedure should be undertaken with the outcome and their safety being the central focus of attention for all those involved with their care. Audit of the quality of care delivered should be undertaken, and its implementation and subsequent refinement should be with the wholehearted involvement and cooperation of interventional cardiologists. If centres and operators are to be assessed, and occasionally judged to be failing, such failings should be the result of their own shortcomings and not those of a system with wider inadequacies, for which others may more appropriately bear responsibility. The government's emphasis on clinical governance highlights the importance of this diverse responsibility.

In 1996 a previous British Cardiac Society (BCS)/British Cardiovascular Intervention Society (BCIS) working group published guidelines for the best practice of coronary angioplasty,1, and these were subsequently endorsed in the Scottish intercollegiate document on coronary revascularisation.2 The guidelines were based on a consensus of professional judgement, and placed some reliance on the volume of procedures undertaken by operators and institutions. It was recognised that numbers of procedures represented a poor surrogate for measures of quality, and that more meaningful indicators were required. The purpose of this paper is to define the indicators relevant to the delivery of a quality interventional cardiology service, the means by which these indicators might be assessed, and the training required for those who will become interventional cardiologists in the future.

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