Index PCI
angioplasty
COMPLICATIONS
Before the procedure, a loading dose of aspirin (300 mg) and P2Y12 inhibitor (600 mg of clopidogrel, 180 mg of ticagrelor, or 60 mg of prasugrel) will be administered to all patients if not used at least 12 h before the PCI procedure. Unfractionated heparin will be used during the procedure to maintain an activated clotting time of > 250 s. An additional dose of 3000 IU of heparin will be added if the procedure extends beyond 1 h. Administration of glycoprotein IIb/IIIa inhibitors will be left to the physician’s discretion. Balloon angioplasty and stent implantation will be performed according to the standard techniques. Intracoronary nitrate will be administered during PCI, typically as a 200–300 mcg bolus. The stent diameter in the nitrate group will be selected via visual estimation or imaging study after the intracoronary nitrate administration, while that in the conventional group will be selected via visual estimation or imaging study without the administration of intracoronary nitrate. The goal of the procedure is to achieve the optimal angiographic efficacy of PCI in selected target lesion sites while minimizing the risk of procedure-related complications. A full range of commercially available guiding catheters, balloon catheters, and guidewires will be readily available. Direct stenting and adjuvant post-dilation will be allowed.