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Management of Percutaneous Coronary Intervention Complications: Algorithms From the 2018 and 2019 Seattle

Jacob A Doll1,2, Ravi S Hira1, Kathleen E Kearney1

  • 1University of Washington, Seattle, WA (J.A.D., R.S.H., K.E.K., J.M.M., W.L.).

Circulation. Cardiovascular Interventions
|June 13, 2020
PubMed

Insights

Managing percutaneous coronary intervention (PCI) complications is crucial for patient survival. Developed algorithms offer systematic strategies for recognizing and treating these life-threatening events during complex PCI procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Percutaneous coronary intervention (PCI) complications significantly impact patient survival and healthcare costs.
  • Increasing procedural complexity and patient risk necessitate improved operator preparedness for PCI complications.
  • Limited resources exist for training interventionalists in managing PCI complications, potentially leading to undertreatment of high-risk patients.

Purpose of the Study:

  • To disseminate collective experience in managing PCI complications from high-volume operators.
  • To develop systematic algorithms for the early recognition and effective treatment of PCI complications.
  • To enhance team-based care and preparedness for life-threatening complications during complex PCI.

Main Methods:

  • Conducted 'Learning From Complications: How to Be a Better Interventionalist' courses in 2018 and 2019.
  • Gathered insights from high-volume PCI operators with expertise in chronic total occlusion and high-risk PCI.
  • Developed algorithms focused on early recognition, effective treatment, and team-based management of PCI complications.

Main Results:

  • Algorithms were created to guide the management of PCI complications.
  • Emphasis was placed on a logical and systematic response to life-threatening events.
  • The developed approach aims to improve operator confidence and competence in complex PCI.

Conclusions:

  • An algorithmic approach provides a structured framework for managing PCI complications.
  • These algorithms can aid interventionalists in responding effectively to critical situations.
  • The strategies are intended to support operators performing complex percutaneous coronary interventions.

Keywords:
algorithmshemodynamicspercutaneous coronary interventionrisk

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