What is Percutaneous Coronary Intervention (PCI) or Angioplasty?

PCI, also known as angioplasty, is a medical procedure during which blocked or narrowed arteries that supply blood to the heart are widened to restore blood flow.

The surgeon positions a catheter with a small inflatable balloon on the end within the narrowed section of the artery. The balloon is then inflated pushing outward against the narrowing and surrounding wall of the artery. The inflated balloon opens the narrowed artery by splitting and compressing the plaque and slightly stretching the wall of the artery. A stent is then inserted to maintain the expanded diameter of the artery.

PCI is now being used as an alternative treatment to Coronary Artery Bypass Surgery (CABG) in more than half the cases because it is a less invasive, less expensive and less time-consuming procedure.

Why is PCI necessary?
The purpose of PCI is to widen narrowed or blocked arteries, so that enough blood can get to the heart to deliver the oxygen it needs to function properly.

PCI can be used as an elective procedure to relieve symptoms such as chest pains (angina) and shortness of breath resulting from coronary artery disease or it can be done in an emergency to treat a heart attack and quickly return blood supply to the heart, increasing the chance of survival.

How should I prepare for PCI?
Before PCI is recommended, you will usually have a diagnostic test called Cardiac Catheterization, more commonly known as an Angiogram, to determine the extent of arterial blockage. However, the preparation for both procedures is the same.

Do as much research as you can beforehand so that you will have questions prepared for the doctor.
Make a list of any medication you are currently taking as well as any allergies you might have.
You will probably be asked not to eat or drink anything after midnight on the night before your procedure.
A nurse will shave your groin and upper leg areas as the catheter may be inserted at these points.
Upon admission to the hospital, your preparation prior to treatment will include tests such as an ECG, a chest x-ray, and routine blood tests.
Your doctor will visit you in your hospital room to discuss the procedure in detail and tell you the approximate time for which the procedure is scheduled. He or she will explain the possible risks and benefits and answer any questions you or your family may have.

What should I expect after PCI?
Immediately after procedure:

After the catheter is removed, the cardiologist or another hospital worker will apply heavy pressure to the incision in the groin or arm for about 20 minutes to stop any bleeding, while you lie in bed, remaining still.
ACI utilises vascular closure devices (seals) to help stop bleeding faster (ask your doctor for more information).
It is important to stay in bed for about six hours after PCI. Later, a nurse or medical technician will assist you in getting out of bed and starting to walk around.
Your cardiologist will prescribe certain medication, including Aspirin and other blood-thinning drugs, to be taken for a given period of time after PCI. Therefore it is important that he/she is aware of your allergies to these products.
You will usually be required to stay in the hospital overnight. If no problems such as bleeding or chest pain occur, you should be allowed to go home the following day.
Have a family member or friend drive you home.

At home:

Ensure that you continue taking the medication as prescribed to reduce the possibility of repeat blockages (Restenosis)
Drink lots of fluids to flush the dye out of your system.
For a short period, you should avoid lifting and other activities that might re-open the puncture site wound.
It is safe to return to a desk job almost immediately. However, your doctor may advise waiting for several days before returning to a job that involves using the legs a lot or bending or lifting.
Avoid driving (especially manual transmission) if possible.
It is normal for the puncture site to be tender and bruised, however, any sign of a purplish haematoma (considered a minor complication) or infection should be reported to your cardiologist.
You should immediately contact the cardiologist if any pain, shortness of breath or other symptoms develop after PCI.
Your cardiologist will schedule a return visit In six weeks for a ‘stress test’ to make sure that the arteries have remained open

Some Interesting facts about Angioplasty

In 1977 a young physician, Andreas Gruentzig performed the first Angioplasty in 1977 in Zurich, Switzerland.
Today over two million coronary angioplasties are performed worldwide each year, making it more common than bypass surgery
Angioplasty can be done using one of several instruments attached to the end of a long, thin tube, called a catheter. These instruments include a balloon, a laser, and a drill. Often, they can be used together.
Currently, the most popular approach is balloon Angioplasty in combination with coronary stenting.