Arteries can become narrow and harden which can cause coronary heart disease. The heart needs a constant supply of blood supply, so if it becomes restricted it can lead to chest pain known as angina, usually triggered by physical activity or stress.
If the narrowing suddenly worsens, with a clot forming, then the situation can become unstable, and a heart attack (Acute Myocardial Infarction) can occur.
PCI may be required to restore the blood supply to the heart when medication is ineffective. It is also used as immediate treatment after a heart attack.
You will be given a local anaesthetic before your procedure, meaning you’ll be awake for the duration. A catheter will be inserted into your groin, wrist or arm and fed up through one of your arteries to your heart. The position of the catheter will be constantly monitored by x-ray.
When the catheter is in place, a thin wire will be fed through the catheter and into the affected section of the artery carrying a small balloon. The balloon is inflated to widen the artery, squashing fatty deposits against the artery wall so blood can flow through freely again. The stent is permanently left in place to allow blood to continuously move more freely and to keep the artery open. The stent is covered in medication to help reduce re-narrowing (Drug Eluting Stent or DES) before the balloon, wire and catheter are removed. There are also bare metal stents (BMS) but these are used less often that DES.
This procedure usually takes between 30 minutes to 2 hours to complete depending on complexity.
The majority of patients go home the same day. You will need Aspirin and another agent (Clopidogrel or Ticagrelor) for one year after your procedure.
As with all types of surgery, complications can arise including during or after an angioplasty. The overall risk is usually less than 1%.
Common complications include:
• Bleeding
• Bruising
More serious but less common complications include:
• Damage to the artery-requiring more stents, or emergency surgery
• Excessive bleeding
• Heart attack or stroke
Usually, you stay in a recovery area for several hours after a PCI. You may have bruising or soreness where the doctor inserted the catheter. You might return home that day or stay in the hospital overnight.
Usually, you can resume usual activities within a week after a PCI. If you have a job that requires physical activity or heavy lifting, you may need to wait longer to return to work.
During recovery from a PCI, your cardiologist may prescribe blood-thinning medicines. These drugs, such as clopidogrel (Plavix®), prasugrel (Effient®), or ticagrelor (Brilinta®), lower your risk of blood clots. You should take these medications according to the recommendations of your healthcare provider.