Arteries carry blood to all parts of your body. Heart arteries can become blocked or narrowed by plaque. Plaque is a buildup of fats, cholesterol, and other substances on the inside walls of the arteries.
Percutaneous coronary intervention (PCI) is a procedure in which your healthcare provider inserts a flexible tube called a balloon catheter into a blocked artery in your heart to unblock it. It opens up the artery and allows blood to flow without the need for major surgery. A metal mesh device called a stent is often left in the artery to help keep the blood vessel open. The procedure may also be called coronary angioplasty or percutaneous transluminal coronary angioplasty (PTCA). PCI may be done during a heart attack to reduce heart muscle damage.
PCI is successful over 95% of the time. However, there is risk with every treatment or procedure. Talk to your healthcare provider for complete information about whether any of these risks apply to you.
There are times when the balloon cannot enter the severely narrowed artery.
Sometimes the narrowed or blocked artery will not widen.
You may bleed a lot and need medicine or a blood transfusion.
The artery may be damaged. For example, the catheter might poke a hole in the artery during the procedure. Emergency surgery to repair the hole may be needed.
There is a risk of injury, bleeding, or infection where the catheter was inserted.
How is PCI done?
Before the procedure:
You will be asked to sign a consent form for PCI and angiography. Angiography is an X-ray study of the blood vessels using dye. The consent form will state the reason you are having the PCI, what happens during the PCI, and what you may expect afterward.
Tell your healthcare provider if you are allergic to any medicines.
Tell your provider if you have had kidney problems or an allergy to chemicals, such as contrast dye.
Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or illegal drugs (if any).
You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
During the procedure:
You may be given a sedative through your IV to help you to relax.
You will be given medicine called anesthesia to keep you from feeling pain during the procedure. Local anesthesia numbs the area where the procedure will be done.
Your provider will put a catheter into a blood vessel in your arm or groin. A catheter is a very thin, flexible tube. X-rays are used to help see where the catheter is as it is moved to the blocked artery. A thin wire is guided through the catheter into the narrowed blood vessel. Another catheter is moved forward over the wire. This second catheter has a tiny balloon at its tip.
When the balloon reaches the narrow part of the artery, your provider will inflate the balloon. Inflating the balloon stretches the walls of the narrowed artery. The stretching of the artery greatly improves blood flow through the artery.
A stent may be left in the artery to help keep it open. It may be coated with medicine to help prevent clots.
The provider then deflates the balloon and removes the catheters and wire.
After the procedure:
You will be checked often by nursing staff.
There will be a pressure dressing on the area where the catheter was inserted to prevent bleeding. The dressing will be checked and changed by your provider or the nursing staff as needed.
Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
A heart (cardiac) monitor may be used to keep track of your heart rate and rhythm.
Your provider may prescribe medicines to:
Relax and widen blood vessels and allow blood to flow through them easier
Help prevent blood clots
Reduce blood pressure, slow the heart rate, and reduce the workload of the heart
Control cholesterol levels
Reduce fluid build-up and swelling in the body
Reduce straining with a bowel movement
What can I do to help?
You will need to tell your healthcare team if you have new or worsening:
Chest pain or pressure, squeezing, or fullness in the center of your chest that lasts more than a few minutes, or goes away and comes back (may feel like indigestion or heartburn)
Pain or discomfort in one or both arms or shoulders, or in your back, neck, jaw, or stomach
Breaking out in a cold sweat for no known reason
Along with the previous symptoms, feeling very tired, faint, or sick to your stomach
Pain or numbness in your arm or leg
Bleeding, excess bruising, or a lot of swelling where the catheter was inserted
Dizziness or lightheadedness
Inability to do your normal daily activities
Feeling like your heart is beating too fast, too slow, or skipping beats
Signs of infection around your surgical wound. These include:
The area around your wound is more red or painful
Your wound area is very warm to touch
You have blood, pus, or other fluid coming from the wound area
You have chills or muscle aches
Signs of a problem when you are taking blood thinners, such as:
Red or black bowel movements
Cuts that do not stop bleeding
Ask questions about any medicine, treatment, or information that you do not understand.
How long will I be in the hospital?
How long you stay in the hospital depends on many factors. This is often between 2 to 3 days after you have the procedure.
Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth. Last modified: 2014-07-30 Last reviewed: 2014-07-31
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
US Department of Health & Human Services. (2012) National and regional estimates on hospital use for all patients from the HCUP nationwide inpatient sample. Agency for healthcare research and quality website. Retrieved 07/22/2014 from http://hcupnet.ahrq.gov/HCUPnet.jsp