Complications of PCI and its Management

Contemporary percutaneous coronary intervention (PCI) has few complications and enhanced safety on one hand and on the other hand, available modern tools have enabled interventional cardiologists to venture into more complex patient subsets and fresh challenges in tackling the ensuing newer complications. Individual operators may take several years of experience before being exposed to the complications and hence, it is important to learn from the collective experience on the detection and management of these complications and better equipped to handle them when the need arises. The complications of PCI can be access related or coronary intervention related. The common acute coronary complications include abrupt vessel closure, thrombus, slow flow, dissection, perforation, stent dislodgement, and guidewire fracture and embolization. The chronic complications include late stent thrombosis, in-stent restenosis, and aneurysm formation. The use of imaging, physiology, and plaque modification tools are associated with specific complications which need to be kept in mind while using them. The successful management of complications needs prompt recognition, involving help from others and continued team effort and vigilance.