For many years, bleeding has been perceived as an unavoidable consequence of strategies aimed at reducing thrombotic complications in patients undergoing percutaneous coronary intervention (PCI). However, the paradigm has now shifted towards bleeding being recognized as a prognostically unfavourable event to the same extent as having a new or recurrent ischaemic or thrombotic complication. As such, in parallel with progress in device and drug development for PCI, there is clinical interest in developing strategies that maximize not only the efficacy but also the safety (for example, by minimizing bleeding) of any antithrombotic treatment or procedural aspect before, during or after PCI. In this Review, we discuss contemporary data and aspects of bleeding avoidance strategies in PCI, including risk stratification, timing of revascularization, pretreatment with antiplatelet agents, selection of vascular access, choice of coronary stents and antithrombotic treatment regimens.

多年来，出血一直被认为是旨在减少经皮冠状动脉介入治疗 (PCI) 患者血栓并发症的策略的不可避免结果。然而，现在的范式已经转向出血被认为是一种预后不良的事件，其程度与新的或复发的缺血性或血栓并发症的程度相同。因此，在 PCI 设备和药物开发取得进展的同时，临床上有兴趣开发策略，以最大限度地提高任何抗血栓治疗或手术之前、期间的疗效和安全性（例如，通过最大限度地减少出血）或在 PCI 之后。在这篇综述中，我们讨论了 PCI 中避免出血策略的当代数据和方面，包括风险分层、血运重建时机、