Percutaneous Coronary Intervention
PCI requires cardiac catheterization, which is the insertion of a catheter tube and injection of contrast dye, usually iodine-based, into your coronary arteries. Doctors use PCI to open coronary arteries that are narrowed or blocked by the buildup of atherosclerotic plaque. PCI may be used to relieve symptoms of coronary heart disease or to reduce heart damage during or after a heart attack.
A cardiologist, or doctor who specializes in the heart, will perform PCI in a hospital cardiac catheterization laboratory. You will stay awake, but you will be given medicine to relax you. Before your procedure, you will receive medicines through an intravenous (IV) line in your arm to prevent blood clots. Your doctor will clean and numb an area on the wrist or groin where your doctor will make a small hole and insert the catheter into your blood vessel. Live x rays will help your doctor guide the catheter into your heart to inject special contrast dye that will highlight the blockage. To open a blocked artery, your doctor will insert another catheter over a guidewire and inflate a balloon at the tip of that catheter. Your doctor may put a small mesh tube called a stent in your artery to help keep the artery open.
After PCI, your doctor will remove the catheters and close and bandage the opening on your wrist or groin. You may develop a bruise and soreness where the catheters were inserted. It also is common to have discomfort or bleeding where the catheters were inserted. You will recover in a special unit of the hospital for a few hours or overnight. You will get instructions on how much activity you can do and what medicines to take. You will need a ride home because of the medicines or anesthesia you received. Your doctor will check your progress during a follow-up visit. If a stent is implanted, you will have to take special anticlotting medicines exactly as prescribed, usually for at least three to 12 months.
Serious complications from PCI don’t occur often, but they can happen. These complications may include bleeding, blood vessel damage, a treatable allergic reaction to the contrast dye, the need for emergency coronary artery bypass grafting during the procedure, arrhythmias, damaged arteries, kidney damage, heart attack, stroke, or blood clots. Sometimes chest pain can occur during PCI because the balloon briefly blocks blood supply to the heart. Restenosis, or tissue regrowth in the treated portion of the artery, may occur in the following months and cause the artery to become narrow or blocked again. The risk of complications is higher if you are older, have chronic kidney disease, are experiencing heart failure at the time of the procedure, or have extensive heart disease and multiple blockages in your coronary arteries.
Visit Angioplasty and stent placement - heart for more information about this topic.