CARE OF THE PATIENT AND MANAGEMENT OF COMPLICATIONS AFTER PERCUTANEOUS CORONARY-ARTERY INTERVENTIONS

Certain aspects of patient management are common with conventional bal loon angioplasty and newer coronary artery interventions. These aspect s include the evaluation of chest pain or treatment of acute vessel cl osure shortly after the intervention, management of the vascular acces s site (especially if complications occur), prevention and treatment o f contrast-induced renal dysfunction, and the use of anticoagulant or antiplatelet agents after the procedure. However, some aspects of mana gement vary among techniques. Several different drug therapies are ind icated after these procedures, but pharmacologic therapy for restenosi s has been largely unsuccessful. Placement of an intracoronary stent d ecreases the frequency of restenosis and subsequent revascularization procedures, and functional testing may be of value in some patients af ter coronary artery interventions. It is important for the specialist in internal medicine to have a firm working knowledge of the various a spects of care that are required because their role in management is i ncreasing.