Indications and contraindications for PCI
| Clinical indications | Angiographic indications | |
| Angina pectoris | 1–4 lesions amenable to PCI | |
| –de novo angina pectoris | –not immediately life threatening | |
| –stable angina pectoris | –vessel diameter ⩾2.5 mm | |
| –unstable angina pectoris –recurrent angina pectoris –after PCI (restenosis) –after CABG (graft attrition) | –lesion(s) subtending function, viable, or collateral dependent myocardium Angiographic contraindications (relative) Left main stenosis (exceptions: protected | |
| Angina equivalent –arrhythmias, sudden death survivors –dyspnoea –dizziness | by graft or collaterals, ideal lesion, inoperable patient\) Left main equivalent stenoses (exceptions: staged procedure, ideal lesions, inoperable patient) Lesion characteristics Chronic total occusion –no collaterals to distal artery –long and old –no stump –extensive bridging collaterals Thrombotic stenosis with non-significant underlying lesions Diffusely diseased, small calibre native coronary artery Diffusely diseased old venous vein graft | |
| Myocardial infarction –acute myocardial infarction (primary PCI) –postinfarct angina pectoris –rescue PTCA (failed thrombolysis, cardiogenic shock) | ||
| Objective signs of reversible ischaemia –resting ECG –exercise induced ischaemia | ||
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Clinical contraindications –rapidly terminal cardiac or other systemic disease |