ABSTRACT
Complications of percutaneous coronary intervention (PCI) may have
significant impact on patient survival and healthcare costs. PCI
procedural complexity and patient risk are increasing, and operators
must be prepared to recognize and treat complications, such as
perforations, dissections, hemodynamic collapse, no-reflow, and
entrapped equipment. Unfortunately, few resources exist to train
operators in PCI complication management. Uncertainty regarding
complication management could contribute to the undertreatment of
patients with high-complexity coronary disease. We, therefore,
coordinated the Learning From Complications: How to Be a Better
Interventionalist courses to disseminate the collective experience of
high-volume PCI operators with extensive experience in chronic total
occlusion and high-risk PCI. From these conferences in 2018 and 2019, we
developed algorithms that emphasize early recognition, effective
treatment, and team-based care of PCI complications. We think that an
algorithmic approach will result in a logical and systematic response to
life-threatening complications. This construct may be useful for
operators who plan to perform complex PCI procedures.