Percutaneous Coronary Intervention: Before Your Procedure

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What is percutaneous coronary intervention?

Balloon and stent in a coronary artery

Percutaneous coronary intervention (PCI) is the name for procedures to open a blocked or narrow blood vessel that gives oxygen to the heart (coronary artery). Opening the artery helps to restore blood flow to the heart. This can relieve angina symptoms such as chest pain or pressure. PCI also may help prevent a heart attack. PCI procedures include coronary angioplasty and coronary stent placement.

Angioplasty can open a narrowed or blocked coronary artery. It can be done during or after a heart attack. It restores blood flow to your heart. This can help prevent heart problems. It may also be called balloon angioplasty.

Before an angioplasty, a doctor does a test, called a coronary angiogram. This finds narrowed or blocked arteries. The doctor inserts a thin, flexible tube called a catheter into an artery in your upper leg (groin) or arm. The doctor moves the catheter through that artery to the arteries on the outside of the heart. He or she then puts a dye into the catheter. This makes your heart's arteries show up on a screen so the doctor can see any arteries that are blocked or narrowed.

If you have a blocked or narrow artery, the doctor may do an angioplasty or stent placement. The doctor uses a catheter with a tiny balloon at the tip. He or she puts it into the blocked or narrow area and inflates it. The balloon presses the fatty buildup (plaque) against the walls of the artery. This creates more room for blood to flow. In most cases, the doctor then puts a stent in the artery. A stent is a small, wire-mesh tube that presses against the walls of the artery. The stent is left in the artery to keep the artery open and to help blood flow.

The procedure may take 30 to 90 minutes. But you need time to get ready for it and time to recover. It can take several hours total. You will likely stay 1 night in the hospital.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before the procedure?

Having a procedure can be stressful. This information will help you understand what you can expect and how to safely prepare for your procedure.

Preparing for the procedure

  • Bring a list of questions to ask your doctors. It is important that you understand exactly what procedure is planned, the risks, benefits, and other options before your procedure.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia. Your doctor will tell you which medicines to take or stop before your procedure.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your procedure. Make sure that you understand exactly what your doctor wants you to do.
  • You may need to stop taking certain medicines a week or more before your procedure, so talk to your doctor as soon as you can.
  • You may have several tests before the procedure. These may include X-rays, blood tests, and an electrocardiogram (EKG) to check the electrical activity of your heart.
  • Arrange for someone to take you to the hospital and back home after the procedure.
  • You may be told to stop eating before the procedure. You will be given exact instructions for your procedure.

Taking care of yourself before the procedure

  • Build healthy habits into your life. Changes are best made several weeks before the procedure, since your body may react to sudden changes in your habits.
    • Stay as active as you can.
    • Eat a healthy diet.
    • Cut back or quit alcohol and tobacco.
  • If you have an advance care plan, let your doctor know. If you do not have one, you may want to prepare one so your doctor and loved ones know your health care wishes. Doctors recommend that everyone prepare these papers before a procedure, regardless of the type of procedure or condition.

What happens on the day of the procedure?

  • Follow the instructions exactly about when to stop eating and drinking, or your procedure may be cancelled. If your doctor has instructed you to take your medicines on the day of the procedure, please do so using only a sip of water.
  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do NOT shave the procedure site yourself.
  • Remove all jewellery, piercings, and contact lenses.
  • Leave your valuables at home.

At the hospital or surgery centre

  • Bring a picture ID.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The procedure will take 30 to 90 minutes.
  • If the catheter was put in your groin, you will need to lie still and keep your leg straight for several hours. The nurse may put a weighted bag on your leg to help you keep it still.
  • If the catheter was put in your arm, you may be able to sit up and get out of bed right away. But you will need to keep your arm still for at least one hour.

Going home

  • You will need someone to drive you home.
  • Ask your doctor when you can drive again.
  • You will be given more specific instructions about recovering from your procedure, including activity and when you may return to work.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.

Where can you learn more?

Go to http://www.healthwise.net/ed

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Current as of: January 27, 2016