PCI Guidelines: History and Evolution In 1982, a 2-page manuscript titled Guidelines for the Performance of Percutaneous Transluminal Coronary Angio- plasty was published in Circulation.4 The document, which addressed the specific expertise and experience physicians should have to perform balloon angioplasty, as well as laboratory requirements and the need for surgical support, was written by an ad hoc group whose members included Andreas Gru ntzig. In 1980, the ACC and the AHA estab- lished the Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures, which was charged with the development of guidelines related to the role of new therapeutic approaches and of specific noninvasive and inva- sive procedures in the diagnosis and management of cardio- vascular disease. The first ACC/AHA Task Force report on guidelines for coronary balloon angioplasty was published in 1988.5 The 18-page document discussed and made recom- mendations about lesion classification and success rates, indications for and contraindications to balloon angioplasty, institutional review of angioplasty procedures, ad hoc angio- plasty after angiography, and on-site surgical backup. Further iterations of the guidelines were published in 1993,6 2001,7 and 2005.8 In 2007 and 2009, focused updates to the guideline were published to expeditiously address new study results and recent changes in the field of interventional cardiology.9,10 The 2009 focused update is notable in that there was direct collaboration between the writing commit- tees for the STEMI guidelines and the PCI guidelines, resulting in a single publication of focused updates on STEMI The evolution of the PCI guideline reflects the growth of knowledge in the field and parallels the many advances and innovations in the field of interventional cardiology, includ- ing primary PCI, BMS and DES, intravascular ultrasound (IVUS) and physiologic assessments of stenosis, and newer antiplatelet and anticoagulant therapies. 