Percutaneous Coronary Intervention and Bleeding Complications

*Sudhakar George,1 Rob Butler,1,2 James Nolan,1,2 Mamas A. Mamas1,2

1. Royal Stoke University Hospital, Stoke-on-Trent, UK
2. Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK
*Correspondence to sudhakargeorge@gmail.com

Disclosure: The authors have declared no conflicts of interest.
Received: 04.12.15 Accepted: 18.04.16
Citation: EMJ Int Cardiol. 2016;4[1]:100-109.

Abstract

Percutaneous coronary intervention (PCI) is the most common form of revascularisation in patients with coronary artery disease in both the elective and acute coronary syndrome settings. Advances in pharmacotherapy have reduced ischaemic complications and improved outcomes in PCI, albeit at the expense of major bleeding. Major bleeding complications are amongst the most common to occur following PCI, with varying incident rates reported due to different definitions of what constitutes a ‘major bleeding event following PCI’, and the risk profile of the patients studied. Irrespective of the bleeding definition used, major bleeding events universally lead to a worse outcome. Major bleeds can occur at both the access site used for PCI and non-access site sources. Both access site and non-access site bleeding increase mortality following PCI. Patients who undergo PCI are at an increased risk of bleeding for several years following the procedure. Strategies to reduce the risk of bleeding should focus on pharmacotherapy, and importantly, use a radial rather than femoral approach to perform PCI.

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