PCI

Question 1

Why should a patient not be completely sedated during percutaneous coronary intervention (PCI)?

Answer 1

They must be able to maintain their own airway.

Question 2

What are the medications required after a bare metal stent is placed?

Answer 2

ASA for life
Clopidogrel for up to 1 month (any thienopyridine)

-takes about 1 mo for scare tissue to form around the metal stent. Higher risk of re-stenosis

Question 3

What are the medication required after a drug-eluted stent is placed?

Answer 3

ASA for life
Clopidogrel or Prasugrel for 1 year

-the stent prevents intimal hyperplasia and is exposed for a longer period of time which is why antiplatelet drugs are needed for longer. Decreases chance of re-stenosis.

Question 4

What is the main goal of PCI?

Answer 4

Improve QOL by reducing symptoms of ACS.

Question 5

One complication of PCI is a hematoma. How is it treated?

Answer 5

Usually caused by poor closure of access site.

• manual compression
• IV fluid
• pain control

Question 6

What complication of PCI shows a presentation of hypotension, backpain, and bradycardia? How is it treated?

Answer 6

Retroperitoneal Hematoma (usually caused by anticoagulants)

• compression of access site
• IV fluids
• imaging for confirmation

Question 7

How would a physician diagnose a pseudoaneurysm caused by PCI?

Answer 7

Ultrasound or auscultation of bruits somewhere along the path of the PCI procedure.

Question 8

How is the pseudoaeurysm treated?

Answer 8

Thombin injection
IV fluids
Sometimes surgery

Question 9

What is the best way to prevent acute renal failure post PCI?

Answer 9

Hydration 3x

Question 10

What is the cause of Blue Toe Syndrome?

Answer 10

Embolus or microembolus of cholesterol 2-3 weeks post catheter placement.