This review provides clinical recommendations for managing acute gastrointestinal bleeding in patients following percutaneous coronary intervention, emphasizing the balance between arresting hemorrhage and preventing ischemic complications.
May inform balancing of bleeding and ischemic risks post-PCI; leaves open need for prospective validation of recommendations.
Bleeding from the GI tract is a commonly encountered clinical problem after percutaneous coronary intervention. The GI tract is likely to become the most commonly encountered site of bleeding as cardiologists adopt smaller access sheath sizes, percutaneous closure devices and a radial artery approach, further reducing access-site bleeding. To appropriately manage gastrointestinal bleeding in this setting, the clinician must strike a balance between arresting hemorrhage and preventing ischemic coronary complications. To do so, an appreciation of both cardiovascular and gastrointestinal issues is required. This review aims to provide the required knowledge, as well as a series of recommendations from our practice, to assist in the management of this potentially fatal complication.
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Wallace et al. (2012) studied this question.
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