Interventional cardiology

Angiography and PCI complications in claims.

Expert witness reports on dissection, coronary perforation, acute stent thrombosis and access-site haemorrhage — whether the complication was foreseeable and managed within accepted standards.

Instruct a cardiology expert Call 0800 161 3395
  • PCI dissection & perforation
  • Stent thrombosis & malposition
  • Access-site haemorrhage
  • Bolam · Bolitho · Montgomery
what we cover

The procedural risks and the legal questions they raise.

Coronary angiography and PCI are invasive procedures with recognised complications. Dissection, perforation, acute stent thrombosis and access-site haemorrhage can lead to myocardial infarction, tamponade or death. The legal questions turn on whether the complication was foreseeable, whether the interventional cardiologist acted within accepted standards, and whether timely recognition and management mitigated harm.

Our consultants assess whether the complication was managed in line with current NICE and ESC interventional guidance — whether the procedural technique adhered to accepted practice, whether intra-procedural monitoring was adequate, and whether post-complication management followed accepted protocols.

  • Breach questions address whether the procedural technique adhered to accepted standards, whether intra-procedural monitoring was adequate, and whether the complication was recognised and managed in time.
  • Causation questions focus on whether timely intervention would have prevented or mitigated the harm, and whether the complication was a direct result of the alleged breach. Where it led to myocardial infarction, the report addresses whether earlier recognition would have altered the outcome.
  • Consent and information under Montgomery is frequently in issue — whether the patient was informed of the material risks of the procedure, judged from the position of a reasonable patient.
  • Post-procedural care is assessed against current guidance — whether monitoring was adequate, complications promptly recognised, and escalation to surgical or intensive care timely.
Clinical scope

The procedural questions our cardiologists answer.

Reports address the interventional cardiology decisions in issue against current guidance and the Bolam and Bolitho standard.

Included in scope

Questions addressed

  • Whether the procedural technique adhered to accepted standards, including guidewire manipulation, balloon inflation pressures and stent deployment.
  • Whether intra-procedural monitoring — ECG, haemodynamic parameters and fluoroscopy — was adequate to detect complications early.
  • Whether the complication was recognised and managed in time, in line with current interventional practice.
  • Whether post-procedural care — monitoring, antiplatelet therapy and escalation — followed accepted protocols and mitigated harm.
  • Whether the patient was informed of the material risks of the procedure, and whether the information provided met the Montgomery standard.
Out of scope

Not covered without separate instruction

  • Acute coronary syndrome management without a procedural complication, which sits with general and acute cardiology instruction.
  • Cardiothoracic surgical decisions where emergency CABG was required, addressed via cardiac surgery instruction.
  • Examination of the claimant or prognosis evaluation, which requires a separate condition and prognosis report.
  • Quantum, life expectancy and care needs, addressed through dedicated reports where the case progresses to that stage.
Common cases

Common procedural scenarios we report on.

These patterns recur in PCI complications claims, most turning on whether the complication was managed within accepted standards.

  • PCI · Dissection

    Coronary artery dissection during PCI

    Guidewire or balloon inflation caused a coronary dissection; a flow-limiting flap led to acute ischaemia. The report addresses whether the technique adhered to accepted standards, whether the dissection was promptly recognised, and whether stenting or surgical intervention was timely.

    Often paired with: Breach of Duty Causation

  • PCI · Perforation

    Coronary perforation with tamponade

    Balloon inflation or stent deployment caused a coronary perforation; haemopericardium led to tamponade. The report examines whether the perforation was recognised in time, whether pericardiocentesis was prompt, and whether surgical repair was escalated appropriately.

    Often paired with: Breach of Duty Missed MI

  • PCI · Stent thrombosis

    Acute stent thrombosis post-PCI

    Stent thrombosis occurred within hours of PCI; the patient re-presented with STEMI. The report addresses whether antiplatelet loading was adequate, whether stent malposition was recognised, and whether timely re-intervention was performed.

    Often paired with: Screening & Merits Breach of Duty

  • Access-site · Haemorrhage

    Femoral artery haemorrhage post-angiography

    Retroperitoneal haemorrhage followed femoral access; hypotension was misattributed to sedation. The report tests whether post-procedural monitoring was adequate, whether the haemorrhage was recognised in time, and whether transfusion or surgical repair was escalated appropriately.

    Often paired with: Causation Condition & Prognosis

Reports

Report types commissioned for PCI complications.

These cases typically progress from screening into full liability work, with breach and causation often addressed together.

Approaching a deadline?

Instruct an expert in angiography and PCI complications.

Send a short note on the alleged procedural failings with the records bundle. Quotation returned the same working day; fast-track available where the trial window or limitation deadline requires it.

Instruct a cardiology expert Call 0800 161 3395

GMC-registered consultants Fixed fee where the bundle allows LAA rates available