Sawano M, Spertus JA, Masoudi FA, et al. - Researchers analyzed the time trend as well as the impact of bleeding avoidance strategy (BAS) utilization among 19,656 consecutive Japanese percutaneous coronary intervention (PCI) patients, in collaboration with the National Cardiovascular Data Registry (NCDR) CathPCI registry. The participants were split into four-time frame categories (T1: 2008-2011, T2: 2012-2013, T3: 2014-2015, and T4: 2016-2018). Use of transradial approach or vascular closure device use following transfemoral approach defined BAS. In the Japanese population, good discrimination was shown by the NCDR CathPCI bleeding risk score (C-statistics 0.79-0.81). A rise from 43% (T1) to 91% (T4) was noted in BAS adoption rate, whereas a reduction in the crude CathPCI-defined bleeding rate from 10% (T1) to 7% (T4) was reported. Overall, findings revealed lower risk of bleeding complications among Japanese in relation to BAS use over the studied time frames. Nonetheless, noted bleeding rates continued to be higher vs the US population.