Bleeding avoidance strategies during percutaneous coronary interventions.

Bleeding avoidance strategies for percutaneous coronary interventions continue to evolve with the availability of newer antiplatelet and anticoagulation therapies. Advances in interventional practices have altered the balance between ischemic and bleeding complications. With the availability of rapidly-acting platelet adenosine diphosphate-receptor antagonists, the need for routine glycoprotein IIb/IIIa inhibitors has diminished. Recent meta-analyses and trials have advanced our knowledge of vascular access and different anticoagulation regimens. Vascular closure devices have long been used for early ambulation; however, more recent results demonstrating lower bleeding complications from observational registries are encouraging. This review synthesizes this information, taking into account changes in the landscape of interventional practice with respect to current bleeding avoidance strategies.