Biswas S, Dinh D, Duffy SJ, et al. - Analysis of a contemporary Australian registry cohort revealed that more than 1 in 20 percutaneous coronary intervention (PCI) attempts were unsuccessful.

• As techniques and pharmacotherapy in PCI are improving, more complex lesions in older patients are now being attempted.

• Of 34,383 single-lesion PCI performed, 18,644 (54.2%) were for acute coronary syndromes.

• An unsuccessful PCI was reported in 2,080 patients (6.0%).

• Older age, previous stroke, PCI, severe left ventricular dysfunction and chronic kidney disease were predictors of an unsuccessful PCI.

• Higher in-hospital and 30-day mortality and MACE were seen with unsuccessful PCI.

• Patient outcomes are strongly impacted by lack of procedural success.

• Monitoring rates of unsuccessful cases represent an essential quality assurance instrument.