Bleeding complications during percutaneous coronary intervention.

Despite improvements in techniques and patient management over the past decade, bleeding complications remain an important problem in the practice of interventional cardiology. One approach to minimize bleeding risk is through refinements in technique. Another important strategy involves selection of the antithrombotic regimen. While any discussion of safety must be set against the backdrop of efficacy, this article focuses especially on the bleeding complications associated with various agents, including heparin and other adjunctive therapies (e.g., glycoprotein IIb/IIIa inhibitors, aspirin, clopidogrel), and whether replacements for heparin, such as bivalirudin or enoxaparin, offer any advantages in terms of bleeding risk.