Ischemic complications after percutaneous transluminal coronary angioplasty

The ischemic complications of percutaneous transluminal coronary angioplast y (PTCA) include abrupt closure, which occurs in 2% to 10% of patients and is associated with increased morbidity and mortality. Periprocedural myocar dial infarction due to side branch occlusion or embolization of platelet ag gregates or thrombus occurs in 5% to 20% of patients. Patients with acute c oronary syndromes, older age, and complex lesions are at greater risk of pe riprocedural complications. Technical advances, primarily stenting, are use ful in the prevention and management of acute closure, but are also accompa nied by thrombotic complications. It remains to be seen whether the new ant ithrombin agents reduce the rate of periprocedural complications if used in combination with aspirin and new antiplatelet therapies. These new antipla telet agents (ticlopidine, clopidogrel, abciximab, eptifibatide, and tirofi ban) reduce the rate of ischemic complications and have become standard adj unctive therapy for patients who undergo PTCA. Am J Med. 2000;108:309-316. (C) 2000 by Excerpta Medica, Inc.