Risk reduction after PCI

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Risk Reduction After PCI
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Factors Associated with Complications Vessel Perforation Dissection Distal Embolization No-reflow Coronary Vasospasm Abrupt Closure Access Site Complications Peri-procedure Bleeding Restenosis Renal Failure Thrombocytopenia Late Acquired Stent Malapposition Loss of Side Branch Multiple Complications
PCI in Specific Patients
Cardiogenic Shock Left Main Coronary Artery Disease Refractory Ventricular Arrhythmia Severely Depressed Ventricular Function Sole Remaining Conduit Unprotected Left Main Patient Adjuncts for High Risk PCI
PCI in Specific Lesion Types
Classification of the Lesion The Calcified Lesion The Ostial Lesion The Angulated or Tortuous Lesion The Bifurcation Lesion The Long Lesion The Bridge Lesion Vasospasm The Chronic Total Occlusion The Left Internal Mammary Artery Multivessel Disease Distal Anastomotic Lesions Left Main Intervention The Thrombotic Lesion
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2007 Focused Update of the PCI Focused Update ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention (DO NOT EDIT)

Comprehensive Risk Reduction for Patients With Coronary and Other Vascular Disease After PCI (DO NOT EDIT)

Smoking (DO NOT EDIT)

“

Goal: Complete cessation, no exposure to environmental tobacco smoke

”

Class I

"1. Status of tobacco use should be asked about at every visit.(Level of Evidence: B)"

"2. Every tobacco user and family members who smoke should be advised to quit at every visit (Level of Evidence: B)"

"3. The tobacco user’s willingness to quit should be assessed (Level of Evidence: B)"

"4. The tobacco user should be assisted by counseling and developing a plan for quitting.(Level of Evidence: B)"

"5. Follow-up, referral to special programs, or pharmacotherapy (including nicotine replacement and pharmacological treatment) should be arranged.(Level of Evidence: B)"

"6. Exposure to environmental tobacco smoke at work and home should be avoided.(Level of Evidence: B)"

Blood Pressure Control (DO NOT EDIT)

“

Goal: Less than 140/90 mm Hg or less than 130/80 mm Hg if patient has diabetes or chronic kidney disease

”

Class I

"1. For patients with blood pressure greater than or equal to 140/90 mm Hg (or greater than or equal to 130/80 mm Hg for patients with diabetes or chronic kidney disease), it is recommended to initiate or maintain lifestyle modification—weight control; increased physical activity; alcohol moderation; sodium reduction; and emphasis on increased consumption of fresh fruits, vegetables, and Low-fat dairy products (Level of Evidence: B)"

"2. For patients with blood pressure greater than or equal to 140/90 mm Hg (or greater than or equal to 130/80 mm Hg for patients with diabetes or chronic kidney disease), it is useful as tolerated, to add blood pressure medication, treating initially with beta blockers and/or ACE inhibitors, with the addition of other drugs such as thiazides as needed to achieve goal blood pressure.(Level of Evidence: A)"