Measuring Success

In order to compare outcomes in PCI across device strategies, it is necessary to use a common vocabulary. Outcomes in percutaneous coronary interventions are categorized in three ways: angiographic success, procedural success, and clinical success. Angiographic success refers to the achievement of a residual stenosis diameter less than 50% in the presence of Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow as defined by the TIMI Trial (5). In the modern era of scaffolding technology such as stents, an additional term, optimal angiographic result, was created to describe the achievement of a postprocedural minimum stenosis diameter of less than 20%. Procedural success requires that angiographic success be coupled to the absence of specific complications during hospitalization (MI, emergent CABG, death). In order to standardize the definition of periprocedural MI, the current American College of Cardiology/American Heart Association (ACC/AHA) Guidelines for Percutaneous Coronary Intervention recommend creatine kinase isoenzyme-cardiac muscle subunit (CK-MB) isoenzyme values threefold higher than the upper limit of normal and do not include the routine use of cardiac troponins or CK (6). Achievement of clinical success requires relief of patients' symptoms, in addition to angiographic and procedural success benchmarks, and is divided into short-term and long-term. Short-term clinical success is achieved if a patient's symptoms are relieved after recovery from the procedure, whereas long-term success requires that relief be durable at 6 mo

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