Background: Evacuation of soldiers with acute coronary syndromes to U.S. hospitals has been the treatment strategy of choice. However, percutaneous coronary intervention (PCI) complication rates have decreased to the point that it is feasible to bring this therapy forward.
Methods: Patients presenting with acute coronary syndromes during Operation Iraqi Freedom (March 2003 to June 2003] were evacuated to Landstuhl Regional Medical Center, Germany. Patients with a high clinical risk but a low interventional risk were selected for unprotected PCI.
Results: PCI was successfully accomplished for 93% of patients (13 of 14 patients). One patient had a 1-month history of progressive angina and a chronic total lesion that could not be crossed. There were no major complications.
Conclusion: Patients with acute coronary syndromes who are risk-stratified can be safely treated with PCI at overseas military hospitals lacking cardiothoracic surgical back-up assistance. This strategy minimizes the risk of transoceanic evacuation of this patient population.