Introduction The incidence of ischaemic complications during percutaneous intervention (PCI) has reduced over recent years. The routine use of stents, ever-improving adjunctive pharmacology, and devices such as rotablation, intra-aortic balloon pumps and aspiration catheters have all served to optomise distal perfusion and minimise ischaemic complications. As a result major bleeding has now emerged as one of the most common complications of PCI in contemporary practice. In addition, measures intended to minimise ischaemic complications may actually increase bleeding risk. Recent studies have highlighted not only the frequency with which major bleeding occurs but demonstrated the importance of bleeding on short and medium-term outcomes. As such bleeding can no longer be considered an irritation that can simply be ignored or transfused.
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