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  • Home | PCI manual

    An algorithmic approach to percutaneous coronary intervention 📚 Search the Chapters 💻 Watch a case 🎙️ Listen to the PCI Manual podcast Click Here 1-Year CHIP-CTO Advanced Fellowship Position Part A ​ The steps Part B Complex subgroups Part C ​ Complications Part D ​ Equipment

  • Part A. The steps | PCI manual

    1. Planning Pre-procedure checklist for cardiac catheterization and PCI 2. Monitoring ​ What to monitor during cardiac catheterization ​ 3. Pharmacology Sedation and analgesia ​ Anticoagulation Antiarrhythmics Vasodilators Contrast media Antiplatelet agents Vasopressors/vasocontstrictors 3. Pharmacology 4. Access Choosing access site Femoral access step-by-step Large bore access Radial access step-by-step Dilator will not go over wire 3. Pharmacology 5. Engagement Engagement via femoral access Engagement via radial access Catheter selection for femoral access Catheter selection for radial access Resistance to guidewire/catheter advancement via femoral access How to exchange catheters over a 300 cm long supportive 0.014 inch guidewire Resistance to guidewire/catheter advancement via radial access How to manipulate catheters to engage via radial access How to manipulate catheters-femoral access ​ How to approach catheter entrapment due to radial artery spasm How to approach catheter kinking 3. Pharmacology 6. Angiography How to perform coronary angiography How to interpret the coronary angiogram 3. Pharmacology 7. Determine target lesion Algorithm for deciding about revascularization in stable angina patients Algorithm for deciding about revascularization in patients with acute coronary syndrome PCI timing, lesion selection, sequence 8. Wiring Wiring: step-by-step Wiring: key principles How to remove a microcatheter Power microcatheter and power guide extension Wiring through tortuosity 9. Lesion preparation Lesion preparation: When and how How to perform balloon angioplasty How to deliver balloons and stents Lesion preparation algorithm Balloon delivery algorithm Laser 10. Stenting How to perform stenting ​ Labeled stent post-dilation limits 11. Closure Femoral access closure: When and how How to get femoral hemostasis Angioseal step-by-step Perclose step-by-step 12. Physiology Coronary physiology step-by-step 13. Imaging Intravascular imaging: When and which modality? OCT step-by-step IVUS step-by-step 14. Hemodynamic support Hemodynamic support for PCI Impella VA-ECMO

  • Part B. Complex subgroups | PCI manual

    15. Ostial lesions Aorto-ostial lesion treatment Branch-ostial lesion treatment 16. Bifurcations Bifurcation PCI step-by-step ​ Reverse crush steps Provisional stenting steps Culotte stenting steps DK crush steps DK crush troubleshooting 17. Left main Left Main 3. Pharmacology 18. Prior CABG PCI in the prior CABG patient Filterwire Spider 19. Calcification Calcification Rotational atherectomy Orbital atherectomy Rotablator complications 20. Thrombus Thrombus ACS Aspirational thrombectomy 21. CTO Chronic total occlusion SCAD ISR Stent thrombosis Large+ small vessels 22. Other complex lesions (SCAD, stent failure, small/large vessels, long lesions) 23. Balloon uncrossable and undilatable lesions Algorithm for crossing a "balloon uncrossable" lesion Algorithm for crossing a de novo "balloon uncrossable" lesion Algorithm for crossing an in-stent "balloon uncrossable" lesion Balloon undilatable lesions 24. Complex patients (prior TAVR, cardiogenic shock) Prior TAVR Cardiogenic shock

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