Percutaneous Coronary Intervention

Percutaneous Coronary Intervention (PCI), also known as cardiac stenting or angioplasty, is a medical procedure utilized to address coronary artery disease (CAD), a condition characterized by the narrowing or blockage of arteries that supply blood to the heart muscle. Performed by interventional cardiologists, PCI aims to alleviate CAD symptoms, such as chest pain (angina), and enhance blood flow to the heart.

Overview of the Procedure

A thin, flexible tube called a catheter is inserted into the blood vessels of either the groin or the arm.

• Under specialized X-ray guidance (fluoroscopy), the catheter is carefully navigated through the blood vessels until it reaches the narrowed coronary artery.
• Once properly positioned, a balloon-tipped catheter covered with a stent is inflated.
• The balloon compresses the plaque, expanding the stent.
• After plaque compression and stent placement, the balloon is deflated and removed, leaving the stent in the artery to maintain its openness.

During the Procedure

• Most PCIs are conducted with the patient under sedation rather than general anesthesia.
• Most PCIs are conducted with the patient under sedation rather than general anesthesia.
• Local anesthesia is administered at the catheter insertion site (either in the groin or arm).
• When the catheter punctures the skin, the patient may briefly experience a slight sting or pinch and mild pressure while the catheter is maneuvered. Additional pain relief can be administered if needed.
• Once the catheter reaches the heart, contrast dye is released to visualize the narrowed area, which may cause a brief sensation of warmth, flushing, or a metallic taste. Rare side effects like headache or nausea can occur but are typically harmless.
• A catheter with a guidewire inside is inserted. The guidewire is carefully threaded through blood vessels to reach the area of concern.
• If a significant blockage or narrowing is found, a stent may be required. The stent, a small expandable metal mesh tube, is precisely positioned using the guidewire and catheter. Once in place, the stent expands, pushing aside blockages and restoring proper blood flow.
• Following the procedure, the catheter is removed, and a special vascular device or pressure is applied at the insertion site to control bleeding.
• Depending on whether the catheter was inserted in the groin or arm, the patient's leg or arm should be kept straight and elevated for several hours.

After the Procedure

• Patients are typically moved to a recovery room for observation.
• Bed rest is recommended for a period of 2 to 6 hours if procedure is performed through the groin, depending on the individual's condition.
• Pain relief medication may be administered if any discomfort arises.
• Patients are encouraged to consume fluids to aid in the elimination of the contrast dye from their system.
• Following PCI, most patients are discharged home in 6 to 8 hours.