Risks stratification and benefits of PCI

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Percutaneous coronary intervention Microchapters


Patient Information


Risk Stratification and Benefits of PCI

Preparation of the Patient for PCI

Equipment Used During PCI

Pharmacotherapy to Support PCI

Vascular Closure Devices

Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT

Post-PCI Management

Risk Reduction After PCI

Post-PCI follow up

Hybrid coronary revascularization

PCI approaches

PCI Complications

Factors Associated with Complications
Vessel Perforation
Distal Embolization
Coronary Vasospasm
Abrupt Closure
Access Site Complications
Peri-procedure Bleeding
Renal Failure
Late Acquired Stent Malapposition
Loss of Side Branch
Multiple Complications

PCI in Specific Patients

Cardiogenic Shock
Left Main Coronary Artery Disease
Refractory Ventricular Arrhythmia
Severely Depressed Ventricular Function
Sole Remaining Conduit
Unprotected Left Main Patient
Adjuncts for High Risk PCI

PCI in Specific Lesion Types

Classification of the Lesion
The Calcified Lesion
The Ostial Lesion
The Angulated or Tortuous Lesion
The Bifurcation Lesion
The Long Lesion
The Bridge Lesion
The Chronic Total Occlusion
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]; Associate Editor(s)-in-Chief: Xin Yang, MA(Cantab), MB BChir, MRCP(Lond) Anahita Deylamsalehi, M.D.[2]


There are several risk assessment scores which can help in determining a patient's risk for death, myocardial infarction and recurrent cardiac events.

Risks Stratification and Benefits of PCI

Risk Score Assessment

The TIMI Risk Score for STEMI

The TIMI Risk Score for UA/NSTEMI

The GRACE Risk Score

Risk Stratification Tools

Risk Stratification in the Patient with Stable Angina

Risk Stratification in the Patient with Unstable Angina or Non ST Elevation MI

Risk Stratification in the Patient with ST Elevation MI

Benefits of PCI vs Medical Therapy

In Patients With Stable Angina

In Patients With Unstable Angina or Non ST Elevation MI

In Patients With ST Elevation MI

Benefits of Rescue PCI

Studies demonstrated that rescue PCI after failed fibrinolytic therapy is related to a lower risk of cardiovascular events when compared to repeated fibrinolytic therapy or conservative managements.[1][2][3][4]


  1. 1.0 1.1 Sutton AG, Campbell PG, Graham R, Price DJ, Gray JC, Grech ED; et al. (2004). "A randomized trial of rescue angioplasty versus a conservative approach for failed fibrinolysis in ST-segment elevation myocardial infarction: the Middlesbrough Early Revascularization to Limit INfarction (MERLIN) trial". J Am Coll Cardiol. 44 (2): 287–96. doi:10.1016/j.jacc.2003.12.059. PMID 15261920.
  2. 2.0 2.1 Wijeysundera HC, Vijayaraghavan R, Nallamothu BK, Foody JM, Krumholz HM, Phillips CO; et al. (2007). "Rescue angioplasty or repeat fibrinolysis after failed fibrinolytic therapy for ST-segment myocardial infarction: a meta-analysis of randomized trials". J Am Coll Cardiol. 49 (4): 422–30. doi:10.1016/j.jacc.2006.09.033. PMID 17258087. Review in: ACP J Club. 2007 Jul-Aug;147(1):11
  3. Collet JP, Montalescot G, Le May M, Borentain M, Gershlick A (2006). "Percutaneous coronary intervention after fibrinolysis: a multiple meta-analyses approach according to the type of strategy". J Am Coll Cardiol. 48 (7): 1326–35. doi:10.1016/j.jacc.2006.03.064. PMID 17010790.
  4. 4.0 4.1 Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM; et al. (2022). "2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". J Am Coll Cardiol. 79 (2): e21–e129. doi:10.1016/j.jacc.2021.09.006. PMID 34895950 Check |pmid= value (help).
  5. Armstrong PW, Gershlick AH, Goldstein P, Wilcox R, Danays T, Lambert Y; et al. (2013). "Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction". N Engl J Med. 368 (15): 1379–87. doi:10.1056/NEJMoa1301092. PMID 23473396.
  6. Mason PJ, Shah B, Tamis-Holland JE, Bittl JA, Cohen MG, Safirstein J; et al. (2018). "An Update on Radial Artery Access and Best Practices for Transradial Coronary Angiography and Intervention in Acute Coronary Syndrome: A Scientific Statement From the American Heart Association". Circ Cardiovasc Interv. 11 (9): e000035. doi:10.1161/HCV.0000000000000035. PMID 30354598.

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