METHODS: Clinical trials from a targeted three-stage PubMed search, focusing on PCI indications, procedural timing, and device selection, were analyzed and integrated with consensus guidelines from leading cardiology organizations.

RESULTS: For patients presenting with ST-elevation myocardial infarction (STEMI), PCI is recommended within 12 h of the onset of symptoms, ideally achieving a door-to-balloon time of 90-120 min from the first medical contact. Beyond the 12 h mark, the procedure remains indicated for those exhibiting persistent ischemia, clinical symptoms, or complications such as shock, arrhythmia, or heart failure. In cases of non-STEMI (NSTEMI), patients generally benefit from PCI during their initial hospital stay, although an early invasive approach may not provide clinical advantages for frail elderly individuals. Complete revascularization is typically favored over treating only the culprit lesion, except in instances of cardiogenic shock. For those with chronic coronary syndrome (CCS), while PCI enhances quality of life and improves symptom management, most clinical trials report that it does not significantly reduce mortality or major cardiovascular incidents. The initial plain old balloon angioplasty faced complications of restenosis and acute vessel closure. While bare metal stents addressed acute closure, the problem of restenosis persisted and stent thrombosis was noted. Current drug-eluting stents (DESs) are the preferred choice owing to superior clinical outcomes, with lower restenosis and stent thrombosis rates. Although theoretically ideal, bioresorbable scaffolds (BRSs) are still undergoing further research since they have yet to prove superior to DESs in clinical trials. In addition, drug-coated balloons (DCBs) have become a specialized treatment, especially for managing in-stent restenosis.