Angioplasty / PCI

Percutaneous Coronary Intervention

Also known as  Coronary Angioplasty,it is a non-surgical procedure used to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease. These stenotic segments are due to the build up of the cholesterol-laden plaques that form due to atherosclerosis. PCI is usually performed by an interventional cardiologist, though it was developed and originally performed by interventional radiologists.

During PCI, a cardiologist feeds a stent mounted on a balloon through a catheter from the femoral artery in the groin, or the radial artery in the wrist up through blood vessels until they reach the site of blockage in the heart. X-ray imaging is used to guide the catheter threading. At the blockage, the balloon is inflated to open the artery, allowing blood to flow. A stent is often placed at the site of blockage to permanently open the artery.

Who needs PCI?

Many patients with angina (which may present as chest pain or breathlessness) can be helped with PCI. The procedure can offer relief of symptoms and an improved quality of life. The decision to undertake PCI is taken after a coronary angiogram has been performed. The need for PCI will depend on the severity of symptoms and the extent of disease seen within the coronary arteries. In some cases, PCI is not the right treatment option, and these individuals may continue on tablet treatment, or if extensive disease is found, may be offered bypass surgery.

We will discuss all aspects of your individual case before proceeding with PCI. In many cases, a decision on the most appropriate treatment will be taken by a group of doctors, including cardiologists and cardiothoracic surgeons. This allows the best treatment to be offered to each individual patient

What are the risks of PCI, and what is the success rate?

PCI is a very low risk procedure in experienced hands, with a serious complication rates occurring in around 1 in 100 cases.

The success rates for PCI are very high, running at around 98%. The success of the procedure will depend on a number of factors, some of which are related to the procedure itself, and others to the patient.

In most patients, treatment with PCI will offer an immediate improvement in their symtpoms which will continue for many years. In a small proportion of patients, the area treated by the stent will re-narrow or ‘restenose’. This happens in around 5% of patients, and is reduced by the use of new ‘drug-cotated’ stents. If this does occur, further treatment to the artery may be needed, usually with further PCI.