An algorithmic approach developed from high-volume operator experience emphasizes early recognition, effective treatment, and team-based care for managing life-threatening PCI complications.
Provides an algorithmic approach to managing life-threatening PCI complications, derived from the experience of high-volume operators.
Complications of percutaneous coronary intervention (PCI) may have significant impact on patient survival and healthcare costs. PCI procedural complexity and patient risk are increasing, and operators must be prepared to recognize and treat complications, such as perforations, dissections, hemodynamic collapse, no-reflow, and entrapped equipment. Unfortunately, few resources exist to train operators in PCI complication management. Uncertainty regarding complication management could contribute to the undertreatment of patients with high-complexity coronary disease. We, therefore, coordinated the Learning From Complications: How to Be a Better Interventionalist courses to disseminate the collective experience of high-volume PCI operators with extensive experience in chronic total occlusion and high-risk PCI. From these conferences in 2018 and 2019, we developed algorithms that emphasize early recognition, effective treatment, and team-based care of PCI complications. We think that an algorithmic approach will result in a logical and systematic response to life-threatening complications. This construct may be useful for operators who plan to perform complex PCI procedures.
Doll et al. (2020) conducted a review in Percutaneous coronary intervention complications. Algorithmic approach to PCI complication management was evaluated. An algorithmic approach developed from high-volume operator experience emphasizes early recognition, effective treatment, and team-based care for managing life-threatening PCI complications.