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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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A practical approach to the management of percutaneous coronary intervention complications

Tanawat Attachaipanich1, Hafeez Ul Hassan Virk2, Muzamil Khawaja3

  • 1Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States.

Frontiers in Cardiovascular Medicine
|February 23, 2026
PubMed

Insights

Percutaneous coronary intervention (PCI) complications still occur despite advances. Understanding risks and prevention is key to improving outcomes for complex PCI procedures.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Despite advances in stent design, pharmacotherapy, and techniques, percutaneous coronary intervention (PCI) complications persist.
  • Complex PCI procedures are increasing, carrying a higher risk of adverse events.
  • Optimizing procedural outcomes requires understanding risk factors, mechanisms, management, and prevention.

Purpose of the Study:

  • To review current evidence on PCI-associated complications.
  • To identify knowledge gaps in managing and preventing PCI complications.

Main Methods:

  • A narrative review utilizing a focused PubMed search up to October 2025.
  • Prioritization of randomized trials, large observational studies, guidelines, and consensus statements.

Main Results:

  • Acute vessel closure (dissection, thrombosis, perforation) can cause hemodynamic compromise and mortality.
  • Rare device-related complications (entrapment, fracture) pose significant risks.
  • Prevention involves lesion preparation, device selection, gentle manipulation, and imaging; management relies on limited evidence.

Conclusions:

  • Early recognition and prompt management are crucial for reducing adverse PCI outcomes.
  • Future large-scale studies, registry data, and AI-guided modeling are needed for individualized prediction and enhanced procedural safety.
Abstract

Keywords:
ACS—ACS/NSTEMIPCIPCI complicationscomplex PCIpercutaneous coronary intervention (PCI)

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