Table 2. Advantages and disadvantages of different PCI timing in patients undergoing TAVI.

	PCI before TAVI	PCI after TAVI	Combined PCI and TAVI
Advantages	- Easier coronary access (especially for self-expanding THV with a supra-annular leaflet position) - Lower risk of ischaemia-induced haemodynamic instability (i.e., during rapid pacing) - Reduced contrast use compared with concomitant PCI and TAVI	- More reliable FFR/iFR of intermediate lesions - Lower risk of haemodynamic instability during complex PCI (i.e., with rotational atherectomy and impaired LV function) - Reduced contrast use compared with concomitant PCI and TAVI	- Use of the same arterial access - Lower cost
Disadvantages	- Less reliable FFR/iFR assessments of borderline lesions - Higher risk of haemodynamic instability due to AS	- More challenging and potentially compromised coronary access - Less stability and support of the coronary guiding catheter - Potential THV dislodgement	- Larger amount of contrast and higher risk of AKI - Prolonged procedure - Need for DAPT at the time of TAVI, hence increased bleeding risk
AS: aortic stenosis; AKI: acute kidney injury; DAPT: dual antiplatelet therapy; FFR: fractional flow reserve; iFR: instantaneous wave-free ratio; LV: left ventricular; PCI: percutaneous coronary intervention; TAVI: transcatheter aortic valve implantation; THV: transcatheter heart valve