How does PCI accomplish reperfusion, and what is the role of stents in PCI?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

This method of reperfusion entails performing emergent coronary angiography, after establishing arterial access, which can be achieved via the radial or femoral artery. After identifying the anatomy of the coronary circulation and determining the culprit vessel, coronary stents are placed to establish reperfusion.

In patients with STEMI, the evaluation of 70% ST-segment resolution following primary PCI appears to be a 5-year independent predictor of patient-oriented composite endpoint, particularly all-cause death and any revascularization. [81] The investigators suggested it may be used to identify those at high risk of very long-term cardiovascular events.

Drug-eluting stents (DES) or bare-metal stents (BMS) are used. However, if there are financial or social barriers that may limit patient compliance, an increased risk of bleeding, or an anticipated invasive or surgical procedure, the use of DES is not recommended. [2]

Placement of coronary stents requires dual antiplatelet therapy for an extended time period (see Antiplatelet Agents). The duration of therapy is dependent of the type of stent used.


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