Percutaneous Coronary Interventions – Current State of Development: Prevention of Complications and Future Perspectives

Abstract

Antiplatelet therapy is an essential part of cardiovascular prevention in patients with coronary heart disease (CHD). Damage to the vascular wall caused by percutaneous coronary intervention (PCI) is accompanied by extensive platelet activation followed by inevitable risk of thrombosis within implanted stent both in patients with acute coronary syndromes and in those with chronic CHD especially before endothelization is completed. Effective prevention of ischaemic complications necessitates dual antiplatelet therapy including its combination with anticoagulation therapy. Duration of the combined therapy is determined by clinical scenario as well as balancing the risk of ischaemic and haemorrhagic events. Risk assessment is an integral part of patient management. Technological advances in the field of coronary interventions aim to assess atherosclerotic lesions precisely in terms of requirement of revascularization, minimize damage to the vascular wall, promote endothelization, and allow shortening of antithrombotic therapy without losing long-term effectiveness of PCI and increasing the rate of stent thrombosis. The current review discusses prevention of complications after PCI with focus on antithrombotic therapy as well as future perspectives of PCI.