PCI complications: peri procedure bleeding

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PCI Complications

Factors Associated with Complications
Vessel Perforation
Dissection
Distal Embolization
No-reflow
Coronary Vasospasm
Abrupt Closure
Access Site Complications
Peri-procedure Bleeding
Restenosis
Renal Failure
Thrombocytopenia
Late Acquired Stent Malapposition
Loss of Side Branch
Multiple Complications

PCI in Specific Patients

Cardiogenic Shock
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Sole Remaining Conduit
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PCI in Specific Lesion Types

Classification of the Lesion
The Calcified Lesion
The Ostial Lesion
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The Bifurcation Lesion
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Vasospasm
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The Left Internal Mammary Artery
Multivessel Disease
Distal Anastomotic Lesions
Left Main Intervention
The Thrombotic Lesion

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Peri-procedure bleeding is one of the most frequent complications of percutaneous coronary interventions, and independent predictor of mortality.[1]. Although periprocedural bleeding is almost unavoidable clinical complication in coagulopathies, [2] manipulation after a careful evaluation of the patient may help to reduce its frequency. [3]

Peri-procedure Bleeding

2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)[4]

Bleeding Risk (DO NOT EDIT)[4]

Class I

"1. All patients should be evaluated for risk of bleeding before PCI. (Level of Evidence: C)"

References

  1. Ndrepepa G, Berger PB, Mehilli J, Seyfarth M, Neumann FJ, Schömig A, Kastrati A Periprocedural Bleeding and 1-Year Outcome After Percutaneous Coronary Interventions Appropriateness of Including Bleeding as a Component of a Quadruple End Point. J Am Coll Cardiol. 2008 Feb 19;51 (7):690-697 PMID 18279731
  2. Macdonald J, Srinivasan M, More R. Percutaneous Coronary Intervention in a Patient with von Willebrand’s Disease Presenting with an Acute Coronary Syndrome. The Journal of Invasive Cardiology Volume 18 April - Issue 4 - April 2006 - Pages: 174-77
  3. Kong DF, Califf RM, Miller DP, et al. Clinical outcomes of therapeutic agents that block the platelet glycoprotein IIb/IIIa integrin in ischemic heart disease. Circulation 1998;98:2829–2835.
  4. 4.0 4.1 Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). "2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions" (PDF). Journal of the American College of Cardiology. 58 (24): 2550–83. PMID 22070837. doi:10.1016/j.jacc.2011.08.006. Retrieved 2011-12-08. 



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