Percutaneous coronary intervention (PCI) is the name for procedures to open a blocked coronary artery. The two most common are coronary angioplasty and coronary stent placement.
A PCI is a way to open a blocked coronary artery before, during, or after a heart attack. It gets blood flowing to your heart. And it can help prevent heart problems by widening an artery that has been narrowed by fatty buildup (plaque). This also may be called balloon angioplasty.
Before a PCI, a doctor does a test to find blocked arteries. The test is called cardiac catheterization. The doctor puts a tiny tube called a catheter into an artery in your groin or arm. The doctor moves the catheter through the artery to your heart. Then he or she puts a dye into the catheter. This makes your heart's arteries show up on a screen so the doctor can see any blockages. The test also can measure the pressure inside your heart's chambers.
If you have a blocked artery, the doctor may do an angioplasty or a coronary stent procedure. In an angioplasty, the doctor uses a catheter with a tiny balloon at the tip. He or she puts it into the blocked area and inflates it. The balloon presses the plaque against the walls of the artery. This makes more room for blood to flow. In most cases, the doctor then puts a stent in the artery. A stent is a small, expandable tube that presses against the walls of the artery. The stent is left in the artery to keep the artery open. This helps blood flow. It also may keep small pieces of plaque from breaking off and causing a heart attack.
PCI is done in a cardiac catheterization laboratory ("cath lab"). It is done by a heart specialist called a cardiologist. The whole procedure may take 1½ to 3 hours.
You lie on a table under a large X-ray machine. You will get medicine through an IV in one of your veins. It helps you relax and not feel pain. You will be awake during the procedure. But you may not be able to remember much about it.
The doctor will inject some medicine into your arm or groin to numb the skin. You will feel a small needle stick. It's like having a blood test. You may feel some pressure when the doctor puts in the catheter. But you will not feel pain.
The doctor will look at X-ray pictures on a monitor (like a TV set) to move the catheter to your heart. You may feel warm or flushed for a short time when the doctor injects dye into your artery. The doctor then will inflate a tiny balloon at the end of the catheter. The balloon is inflated for a brief time. Then it is deflated and removed. The doctor also may use the catheter to put a stent in the artery.
The catheter will be removed. A nurse or doctor may press on a bandage on the opening. Then a bandage or acompression device may be placed on your groin or wrist at the catheter insertion site. This prevents bleeding. After the test, you will be taken to a room where the catheter site and your heart rate, blood pressure, and temperature will be checked several times. If the catheter was put in your groin, you will need to lie still and keepyour leg straight for several hours. If the catheter was put in your arm, you may be able to sit up and get out ofbed right away. But you will need to keep your arm still for at least one hour. The average hospital stay is 1 to 2days for most procedures. When you go home, you will get instructions from your doctor to help you recover welland prevent problems.
Make sure to drink plenty of fluids (unless your doctor tells you not to) for several hours after the test. This will help flush the dye out of your body.
Your doctor will prescribe blood-thinning medicines. You will likely take aspirin plus another blood thinner. It is very important that you take these medicines exactly as directed. They help keep the coronary artery open and reduce your risk of a heart attack.
If you have this procedure, you will still need to make lifestyle changes like eating healthy, being active, and not smoking. This will give you the best chance for a longer, healthier life.
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 or nurse call line 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.
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Current as of: September 21, 2016
Adam Husney, MD - Family Medicine
& Martin J. Gabica, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & A. Evan Eyler, MD, MPH - Family Medicine, Psychiatry
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