PCI Complications



Editors-In-Chief: Alexandra Almonacid M.D. [mailto:aalmonacid@partners.org] and Jeffrey J. Popma M.D. [mailto:jpopma@partners.org]

Early Clinical Outcomes After PCI

 * Anatomic Success: Residual diameter stenosis < 50 % which is generally associated with at least a 20 percent improvement in diameter stenosis and relief of ischemia.
 * Pre-Stent Era: 72 – 74%.
 * Stent Era: 82 – 98%
 * Procedural Success: Angiographic success without the occurrence of major complications (death, MI, or CABG) within 30 days of the procedure.
 * Clinical Success: Procedural success without the need for urgent repeat PCI or surgical revascularization within the first 30 days of the procedure

Variables Associated with Early Failure and Complications After PCI

 * Clinical variables
 * Women
 * Advanced Age
 * Diabetes Mellitus
 * Unstable or Canadian Cardiovascular Society (CCS) Class IV angina
 * Congestive heart failure
 * Cardiogenic shock
 * Renal insufficiency
 * Preprocedural instability requiring intraaortic balloon pump support
 * Preprocedural Elevation of C-reactive protein
 * Multivessel Coronary Artery Disease
 * Anatomic variables
 * Multivessel CAD
 * Left Main Disease
 * Thrombus
 * SVG intervention
 * ACC/AHA Type B2 and C lesion morphology
 * Chronic total coronary occlusion
 * Procedural factors
 * A higher final percent diameter stenosis
 * Smaller minimal lumen diameter
 * Presence of a residual dissection or trans-stenotic pressure gradient