Primary angioplasty without on-site surgical back-up: the first experience with mobile catheterization facility

The aim of the present study is to assess the safety and efficacy of performing primary angioplasty in a center without on-site surgical back-up, and compare the data with the literature. Seventy-eight consecutive primary angioplasty procedures, performed in our center from January 2001 to February 2003, were followed prospectively. Clinical and demographic characteristics of the patients, procedural success, early and late outcomes of the patients were taken into account. The safety of angioplasty was assessed by the analysis of in-hospital complications (death, urgent need for repeat revascularization, AMI with or without ST-elevation and stroke). The angioplasty procedures were considered effective when the post-procedural residual stenosis did not exceed 50% with the distal Thrombolysis in Myocardial Infarction (TIMI) grade III flow. The device success rate was 92.3%. Angiographic success rate was 88.8%. In hospital mortality rate was 4.1%. These patients were admitted with cardiogenic shock; 1 died during the procedure and the other 2 died during hospital follow-up. One patient died suddenly and another developed acute MI during the 6-month follow-up period. No patients developed stroke or were referred for urgent surgery. Four patients (5.5%) underwent repeat angioplasty during follow-up. Primary angioplasty can be safely performed in centers without on-site surgery. The efficacy and safety requirements of angioplasty, performed in a center without on-site surgical back-up using a mobile catheterization facility were similar to the data obtained from the literature.