Prevention and Management of Percutaneous Coronary Intervention-Related Complications: Assessing the Impact of...

Complications of percutaneous coronary intervention (PCI) remain infrequent but are associated with a risk of serious injury or death. The techniques and devices required to manage them may be unfamiliar or unavailable to operators. Simulation-based learning (SBL) and human factors training (HFT) may serve as tools to increase operator skills and confidence in complication prevention and management.

A survey was given to participants during an SBL program delivered at a major international cardiovascular intervention course in 2023 and 2024. Prior experience with complications, access to equipment, and confidence in managing procedural PCI complications were established. Confidence was then reassessed following SBL training.

A total of 308 cardiologists, from over 50 countries, completed the survey. Access to emergency equipment varied, with half of the operators lacking access to embolic coils. Despite an overall significant procedural experience, many operators were not confident in managing complications. Only 36.9% had undergone any prior HFT, 28.7% reported a lack of confidence in relying on their team, and 26.2% had neutral or negative expectations of obtaining support from colleagues when encountering complications. Structured SBL/HFT significantly improved operator confidence in complication recognition and management.

Effective management of PCI complications requires a practical know-how of specific techniques and access to devices that may not be routinely available. We found that structured SBL and HFT increase operator confidence in complication prevention and management. Further research should seek to investigate long-term outcomes of SBL use in the clinical management of procedural complications.