Key Points Angiography alone is often insufficient to assess intermediate and, at times, severe stenoses. Although adjunctive stress testing has limitations, fractional flow reserve (FFR) provides an accurate detector of lesion specific myocardial ischemia. Deferring revascularization of a coronary stenosis…
Key points Complications remain rare during interventional procedures and prediction tools have been developed to help operators appreciate potential risks before the procedure. Although avoidance of complications remains the primary goal, keen awareness must exist during the procedure to react…
Key points Complex percutaneous coronary intervention (PCI) procedures have become more common as techniques for chronic total occlusions (CTOs), bifurcation, and left main lesions have been developed with improved outcomes. Complex PCI can create significant acute risk for hemodynamic collapse…
Key points Angiographic determination of the significance for a given coronary lesion remains limited. Numerous physiologic indexes are now available that rely on coronary hyperemia (fractional flow reserve [FFR]) and nonhyperemic indexes [aka NHPR] (e.g., instantaneous wave-free pressure ratio [iFR],…
Key points Anticoagulant and antiplatelet medications are required for the safe percutaneous coronary intervention (PCI). Recent studies have demonstrated that shorter durations of dual antiplatelet therapy (DAPT) are safe. Vasodilators and vasopressors may often be necessary in some complicated or…
Key points A significant source of complications from catheterization procedures continues to arise from the site of access. Ultrasound-guided access is the preferred method regardless of access site. There are several options for the best site of access, including the…