7 Implementation and audit

7.1 Clinicians carrying out PCIs should review their current practice and policies to take account of the guidance set out in Section 1.

7.2 Local guidelines, protocols or care pathways that refer to PCIs and/or stents should incorporate the guidance.

7.3 To measure compliance locally with the guidance, the following criteria could be used. Further details on suggestions for audit are presented in Appendix C.

7.4 Stents are used routinely in PCIs carried out in patients with stable or unstable angina or acute MI.

7.5 A Cypher or a Taxus stent is used in PCI for people with symptomatic CAD in whom the target artery is less than 3 mm in calibre or in which the lesion to be stented is longer than 15 mm, except if an individual has had an MI in the preceding 24 hours or has angiographic evidence of thrombus in the target artery. If more than one artery is to have a stent inserted, the same considerations apply to each artery.

7.6 Local clinical audits on the care of patients with CAD also could include measurement of compliance with national standards, including standards in the National Service Framework for coronary heart disease.