The goal of antiplatelet therapy for patients undergoing percutaneous coronary intervention <unk>  is to reduce the<unk>  of ischaemic events without increasing the<unk>  of<unk> . Balancing between the prevention of ischemic events versus minimizing serious<unk>  complications holds the key role and remains as one of the biggest dilemmas in the interventional cardiology practice  
Standard antiplatelet and anticoagulation therapy should be provided to these group of patients unless absolutely contraindicated, demonstrating overall benefit, especially in patients with acute coronary syndromes (ACS).
The<unk>  of<unk>  can be significantly decreased in these groups with an individualized approach as;
Avoiding routine use of glycoprotein IIb/IIIa inhibitors
Considering the level of emergency of the procedure
Evaluating the mechanism of the preexisting hemostasis disorder
Careful monitoring and correction of the deficient factors
Understanding the mechanism of drug action
Proper dosing for half-life specifications,
Adequate knowledge on drug metabolism,
Respective dose adjustment for excretion route
Experience on specific indications for the antithrombotic medications
Additional attention must be given to the arterial puncture site, with longer manual pressure applied after sheath removal, appropriate use of an arterial closure device, or planning of alternative vascular (via radial artery) access for<unk> .
PCI in the patient at risk of bleeding
PCI in the patient with severely depressed ventricular function
PCI in the patient with in stent restenosis
Antiplatelet therapy to support PCI
PCI in the patient with refractory ventricular arrhythmia
PCI in the angulated or tortuous lesion
Coronary artery bypass surgery after failed PCI
PCI in the long lesion