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Updated: Jan 17, 2026
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
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Antithrombotic therapy in complex percutaneous coronary intervention.
Domenico Simone Castiello1, Angelo Oliva2, Giuseppe Andò3
1Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Summary
Optimizing antithrombotic therapy after complex percutaneous coronary intervention (PCI) is crucial. Tailoring treatment to patient profiles and PCI complexity balances ischemic risk and bleeding risk for better outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pharmacology
Background:
- Percutaneous coronary intervention (PCI) is a primary treatment for advanced coronary artery disease.
- Antithrombotic therapy is essential for preventing ischemic events post-PCI.
- Complex PCI presents challenges due to increased bleeding risk.
Purpose of the Study:
- To review current evidence on antithrombotic management after complex PCI.
- To guide personalized antithrombotic strategies based on patient and procedure factors.
- To address optimal treatment in specific complex PCI scenarios.
Main Methods:
- Systematic review of existing literature on antithrombotic therapy in complex PCI.
- Analysis of data regarding dual antiplatelet therapy, P2Y12 inhibitor monotherapy, and dual pathway inhibition.
- Discussion of antithrombotic management in specific patient groups and complex anatomies.
Main Results:
- No single antithrombotic regimen is suitable for all patients undergoing complex PCI.
- Risk stratification is key to balancing ischemic and bleeding risks.
- Specific approaches like prolonged DAPT, P2Y12 monotherapy, and dual pathway inhibition show promise.
Conclusions:
- Personalized antithrombotic strategies are necessary for complex PCI.
- Further research is needed to refine optimal antithrombotic regimens.
- Careful consideration of patient-specific factors and PCI complexity is paramount.
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