Abstract:
Percutaneous coronary intervention (PCI) is considered a relatively safe procedure associated with low rates of complications, but is inevitably associated with short and mid-to-long term increased bleeding risk. Besides the short term risk associated with the arterial access to perform PCI, enhanced bleeding risk persists for several months, given the need for antithrombotic therapy to prevent procedure-related thrombotic complications as well as ischemic recurrences. Bleeding is a powerful harbinger of adverse outcomes. This awareness has fuelled intense research on bleeding reduction strategies, including new PCI devices and techniques as well as new medications and antithrombotic regimens. We here review the mechanisms and prevalence of bleeding in PCI patients, discuss the available evidence from a practical point of view, and explore future perspectives on how to treat and prevent bleeding complications in these patients.
摘要:
经皮冠状动脉介入治疗(PCI)被认为是一种相对安全的手术,并发症发生率低。但不可避免地与短期和中长期出血风险增加有关。除了与动脉介入PCI相关的短期风险外,出血风险增加持续数月,考虑到需要抗血栓治疗以预防手术相关的血栓并发症以及缺血性复发。出血是不良后果的有力预兆。这种意识推动了对减少出血策略的深入研究,包括新的PCI设备和技术以及新的药物和抗血栓治疗方案。我们在这里回顾PCI患者出血的机制和患病率。从实际的角度讨论现有的证据,并探讨如何治疗和预防这些患者的出血并发症的未来前景。