Percutaneous coronary intervention (PCI) has evolved as the standard procedure for the treatment of acute coronary syndromes and for the majority of situations with stable coronary artery disease. Patients aged 75 and older represent one third of those hospitalised with acute ischaemic events and account for more than half of all cardiac deaths. 1 However, evidence-based data to guide coronary revascularisation in the elderly have been limited to 1) the randomised clinical trials that routinely under-enrol elderly patients, and 2) observational studies that represent single institution experience with small samples. 2 Nevertheless, the Western society is an ageing population and the percentage of the population above 80 years of age, the so-called octogenarians, is rapidly increasing in Europe and will almost triple by 2050. 3