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The ‘golden rules’ of percutaneous coronary intervention 

The ‘golden rules’ of percutaneous coronary intervention
Chapter:
The ‘golden rules’ of percutaneous coronary intervention
Author(s):

Rod H. Stables

DOI:
10.1093/med/9780199569083.003.006
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date: 17 February 2020

In the practice of percutaneous coronary intervention (PCI), the usual aim is to deliver maximum clinical gain—at the lowest possible risk—achievable in that specific clinical setting. Most interventionists will accept that PCI has established limitations. The enthusiasm to recommend and perform this form of therapy should be tempered in the light of this reality. Clinical gain can be real but is often modest. Performance can be associated with morbidity and mortality. Alternative therapeutic options exist and are effective.

Other chapters in this textbook will seek to guide on case selection, to refine technique, and to provide an appreciation of available technologies and pharmacotherapy. I believe, however, that substantial improvements in both elements of the ‘risk:benefit’ ratio can be achieved with a re-examination and more universal application of some core, fundamental principles underpinning optimal PCI practice. A talk describing my ‘golden rules of PCI’ has been well-received, by trainees and experienced operators alike, at educational meetings over the last decade and most recipients come to accept my assertion that almost all procedure-related adverse events or suboptimal outcomes can be traced back to a breach of these core concepts.

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