Risk reduction after PCI

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Percutaneous coronary intervention Microchapters

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Patient Information

Overview

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
Dissection
Distal Embolization
No-reflow
Coronary Vasospasm
Abrupt Closure
Access Site Complications
Peri-procedure Bleeding
Restenosis
Renal Failure
Thrombocytopenia
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
Vasospasm
The Chronic Total Occlusion
The Left Internal Mammary Artery
Multivessel Disease
Distal Anastomotic Lesions
Left Main Intervention
The Thrombotic Lesion

Risk reduction after PCI On the Web

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2007 Focused Update of the PCI Focused Update ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention (DO NOT EDIT)[1]

Comprehensive Risk Reduction for Patients With Coronary and Other Vascular Disease After PCI (DO NOT EDIT)[1]

Smoking (DO NOT EDIT)[1]

Goal: Complete cessation, no exposure to environmental tobacco smoke

Class I

"1. Status of tobacco use should be asked about at every visit.(Level of Evidence: B)"

"2.Every tobacco user and family members who smoke should be advised to quit at every visit (Level of Evidence: B)"

"3.The tobacco user’s willingness to quit should be assessed (Level of Evidence: B)"

"4. The tobacco user should be assisted by counseling and developing a plan for quitting.(Level of Evidence: B)"

"5. Follow-up, referral to special programs, or pharmacotherapy (including nicotine replacement and pharmacological treatment) should be arranged.(Level of Evidence: B)"

"6. Exposure to environmental tobacco smoke at work and home should be avoided.(Level of Evidence: B)"

Blood Pressure Control (DO NOT EDIT)[1]

Goal: Less than 140/90 mm Hg or less than 130/80 mm Hg if patient has diabetes or chronic kidney disease

Class I

"1. For patients with blood pressure greater than or equal to 140/90 mm Hg (or greater than or equal to 130/80 mm Hg for patients with diabetes or chronic kidney disease), it is recommended to initiate or maintain lifestyle modification—weight control; increased physical activity; alcohol moderation; sodium reduction; and emphasis on increased consumption of fresh fruits, vegetables, and Low-fat dairy products (Level of Evidence: B)"

"2. For patients with blood pressure greater than or equal to 140/90 mm Hg (or greater than or equal to 130/80 mm Hg for patients with diabetes or chronic kidney disease), it is useful as tolerated, to add blood pressure medication, treating initially with beta blockers and/or ACE inhibitors, with the addition of other drugs such as thiazides as needed to achieve goal blood pressure.(Level of Evidence: A)"

References

  1. 1.0 1.1 1.2 1.3 "2007 Focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 71 (1): E1–40. 2008. doi:10.1002/ccd.21475. PMID 18080332. Retrieved 2012-11-07. Unknown parameter |month= ignored (help)

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