Bleeding avoidance strategies in percutaneous coronary intervention

Davide Capodanno, Deepak L. Bhatt, C. Michael Gibson, Stefan James, Takeshi Kimura, Roxana Mehran, Sunil V. Rao, Philippe Gabriel Steg, Philip Urban, Marco Valgimigli, Stephan Windecker, Dominick J. Angiolillo

Research output: Contribution to journalReview articlepeer-review

110 Scopus citations

Abstract

For many years, bleeding has been perceived as an unavoidable consequence of strategies aimed at reducing thrombotic complications in patients undergoing percutaneous coronary intervention (PCI). However, the paradigm has now shifted towards bleeding being recognized as a prognostically unfavourable event to the same extent as having a new or recurrent ischaemic or thrombotic complication. As such, in parallel with progress in device and drug development for PCI, there is clinical interest in developing strategies that maximize not only the efficacy but also the safety (for example, by minimizing bleeding) of any antithrombotic treatment or procedural aspect before, during or after PCI. In this Review, we discuss contemporary data and aspects of bleeding avoidance strategies in PCI, including risk stratification, timing of revascularization, pretreatment with antiplatelet agents, selection of vascular access, choice of coronary stents and antithrombotic treatment regimens.

Original languageEnglish
Pages (from-to)117-132
Number of pages16
JournalNature Reviews Cardiology
Volume19
Issue number2
DOIs
StatePublished - Feb 2022

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