Galli Mattia, Laborante Renzo, Andreotti Felicita, Vergallo Rocco, Montone Rocco Antonio, Iaconelli Antonio, Trani Carlo, Burzotta Francesco, Crea Filippo, D'Amario Domenico
Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy.
Department of Cardiology, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy.
Rev Cardiovasc Med. 2022 Aug 15;23(8):286. doi: 10.31083/j.rcm2308286. eCollection 2022 Aug.
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.
经皮冠状动脉介入治疗(PCI)被认为是一种相对安全的手术,并发症发生率较低,但不可避免地与短期及中长期出血风险增加相关。除了与进行PCI的动脉通路相关的短期风险外,鉴于需要抗血栓治疗以预防手术相关的血栓并发症以及缺血复发,出血风险会持续数月。出血是不良结局的有力预兆。这种认识推动了对减少出血策略的深入研究,包括新型PCI设备和技术以及新型药物和抗血栓方案。我们在此回顾PCI患者出血的机制和发生率,从实际角度讨论现有证据,并探讨未来如何治疗和预防这些患者出血并发症的前景。