Key Points Periprocedural myocardial necrosis remains a common complication of percutaneous coronary intervention (PCI). The 2012 Third Universal Definition document defines a myocardial infarction (MI) associated with PCI as elevation of troponin values above five times the 99th percentile of…
Key Points Although most complications are avoidable, when they occur, rapid recognition and corrective response are necessary to mitigate adverse consequences such as myocardial infarctions or death. Abrupt closure and intraprocedural stent thrombosis/acute stent thrombosis (<24 hours) are serious complications…
Key Points Thrombus plays a major role in the pathophysiology of acute and chronic ischemic coronary syndromes. Thrombus is a marker of active, unstable atherosclerotic plaques. Plaque rupture, plaque erosion, and calcified nodules are prominent histopathologic components causing coronary thrombosis.…
Key Points Early postoperative ischemia (<30 days) is frequently due to graft occlusion or stenosis, and percutaneous coronary intervention (PCI) is often feasible. Unstable angina or ST–segment–elevation myocardial infarction (STEMI) years after coronary artery bypass grafting (CABG) is most often…
Key Points Chronic total occlusion (CTO) is a common feature in patients with coronary artery disease (CAD) and is a frequent reason for not proceeding with percutaneous coronary intervention (PCI). Observational data suggests that ischemic reduction from successful CTO PCI…
Key Points Myocardial revascularization, which aims to relieve the negative prognostic impact of coronary artery disease left untreated, has emerged as a strategy to improve prognosis and quality of life in patients with multivessel disease (MVD). Over the past four…
Key Points Coronary angiography has limitations in assessing left main coronary artery (LMCA) disease and guiding treatment. The complementary use of coronary physiology and imaging modalities is helpful to improve outcomes following LMCA stenting. Long-term prognosis following ostial or shaft…
Key Points Always consider an ostial lesion as a possible bifurcation lesion, except in cases of aortoostial location. A 6-Fr guiding catheter is appropriate most of the time; when in doubt, use 7- or 8-Fr. Do not risk losing the…
Key Points Cardiogenic shock (CS) remains the leading cause of death among patients hospitalized with acute myocardial infarction (AMI). Left ventricular (LV) dysfunction accounts for most CS in AMI patients. Early restoration of perfusion to the territory supplied by the…
Key Points Comprehensive post-percutaneous coronary intervention (PCI) discharge management is an integral aspect of postprocedure care and includes direct patient communication, monitoring for procedural or vascular complications, and clear discharge instructions with a specific follow-up plan. Medication reconciliation, especially regarding…