Abstract：
Percutaneous coronary interventions (PCI) are the mainstay of treating obstructive coronary artery disease. However, procedural planning and individualization of the procedure is necessary for different patient phenotypes to optimize outcomes. Specifically, post-PCI pharmacotherapy with antiplatelets complicates the management of patients at high bleeding risk due to comorbidities, such as atrial fibrillation. Aiming to limit post-procedural adverse events and reduce the procedure-related bleeding risk, several novel technologies and hypotheses have been tested in clinical practice. Such frontiers include limiting the duration of dual antiplatelet therapy or even prescribing single regimens, using drug-coated balloons for performing the intervention and the effect of imaging-guided PCI in optimizing stent expansion. Furthermore, specific instruction in different patient phenotypes, such as atrial fibrillation and chronic kidney disease, are emerging, as despite both pathologies being considered at high bleeding risk, one size does not fit all. Thus, our review will provide all the recent updates on the field as well as algorithms and expert opinions on how to manage this, particularly common, phenotype of patient.
摘要：
经皮冠状动脉介入治疗（PCI）是治疗阻塞性冠状动脉疾病的主要手段。然而,对于不同的患者表型,程序规划和程序个性化是必要的,以优化结果.具体来说,PCI术后抗血小板药物治疗由于合并症导致高出血风险患者的治疗复杂化,比如心房颤动。旨在限制术后不良事件，降低手术相关出血风险，一些新的技术和假设已经在临床实践中进行了测试。这些领域包括限制双重抗血小板治疗的持续时间，甚至开出单一方案，使用药物涂层球囊进行介入治疗，以及成像引导PCI在优化支架扩张中的作用。此外，不同患者表型的具体指导，比如心房颤动和慢性肾病，正在出现，尽管这两种疾病都被认为是高出血风险的，一个尺寸不适合所有。因此，我们的审查将提供有关该领域的所有最新更新以及有关如何管理此问题的算法和专家意见，特别常见，患者的表型。
