Coronary Artery Disease (CAD) and Angina and Percutaneous Coronary Intervention (PCI)

Percutaneous coronary intervention (PCI) procedures are done to help clear and open arteries that have narrowed in coronary artery disease (CAD).

For more information, see the articles on coronary angioplasty and coronary stenting.

A catheter is inserted into the artery in your groin (or less likely your arm). The catheter, which has a tiny balloon at the tip, is guided into the affected artery using x-ray pictures, displayed on a television monitor that the doctor views. Once in the artery, the balloon is quickly inflated and deflated to stretch open the narrowed portion of blood vessel and restore the passage of blood. Then the balloon and catheter are removed. Under most circumstances, the doctor will place a mesh "inner tube” or stent in the artery to keep it open. The procedure takes about one to two hours to complete, and you will be awake, although sedated, during this time. Newer stents can be used that are coated with a medication to reduce renarrowing of the artery called “restenosis.” These stents are called drug eluting stents.

Read more details about Percutaneous Coronary Intervention (PCI).

A study compared PCI plus optimal medical therapy (intensive medications and lifestyle changes) to optimal medical therapy alone in stable heart patients. Researchers found that adding PCI to treatment did not reduce the risk of death, myocardial infarction (heart attack), or other heart-related events.

If you are planning to have an angioplasty and stent, your doctor will review a list of possible complications which may include:

• Bleeding at the point of catheter insertion
• Damage to the walls of arteries, causing you to need additional procedures or surgery
• Heart attack or arrhythmia (abnormal heart beats)
• Allergic reaction to x-ray dye
• Blood clot formation
• Infection

Some factors that may increase the risk of complications include:

• Allergies to medicines, shellfish, or x-ray dye
• Obesity
• Smoking
• Bleeding disorder
• Age: 60 or older
• Recent pneumonia
• Recent heart attack
• Diabetes
• Kidney disease

Sometimes the procedure is not successful or the artery narrows again. You may require repeat angioplasty or coronary artery bypass grafting (CABG).