[Percutaneous Coronary Intervention in High-Risk Patients]

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiovascular Medicine

Background:

• Severe ischemic heart disease (IHD) with complex coronary artery disease (SYNTAX score >22) often leads to ineligibility for coronary artery bypass grafting (CABG).
• This scenario necessitates alternative revascularization strategies, leading to the concept of "high-risk percutaneous coronary intervention" (PCI).
• Current clinical guidelines often defer treatment decisions for these high-risk patients to a Heart Team consensus.

Purpose of the Study:

• To review and summarize the established criteria for performing high-risk PCI based on existing literature.
• To analyze the impact of various comorbidities on the outcomes of direct myocardial revascularization procedures in high-risk patients.

Main Methods:

• Literature-based analytical review.
• Synthesis of criteria for high-risk PCI.
• Analysis of comorbidity effects on revascularization outcomes.

Main Results:

• The review consolidates criteria defining high-risk PCI candidates.
• Comorbidities significantly influence the results of direct myocardial revascularization in this population.
• The Heart Team approach remains central to treatment strategy determination.

Conclusions:

• High-risk PCI represents a crucial alternative for patients with severe IHD and comorbidities unsuitable for CABG.
• Understanding specific criteria and the influence of comorbidities is essential for optimizing outcomes.
• Further research is warranted to refine indications and evaluate the long-term results of high-risk PCI.