Percutaneous Coronary Intervention, formerly called angioplasty with stent, is a non-surgical method that utilizes a catheter, a long and thin flexible tube, to place a small tool called a stent. This treatment is used to open up the blood vessels in the heart that have narrowed due to buildup plaque or atherosclerosis.
Why is it performed?
Percutaneous Coronary Intervention improves blood flow, therefore decreasing heart-related chest pain, making one’s feel better and it increases one’s ability to be active. PCI might be used to relieve signs of coronary heart disease or to minimize the heart damage during or after a heart attack. PCI can act as an emergency treatment for a heart attack patient or a scheduled procedure to treat chronically inadequate blood flow to the heart.
What can one expect in this procedure?
Primarily, doctors will discuss all the risks and benefits of this procedure. In order to avoid inconveniences, it’s better to inform the doctors about the following details before the procedure begins:
- If one ever had any serious allergy, or ever reacted to any contrast dye.
- If one has asthma, a history of kidney problems or diabetes.
- If one has bleeding problems or is one on blood-thinning medication.
- If one has body piercings on the chest or abdomen.
Before the procedure
Shortly prior to the procedure, one may receive a sedative to help in relaxation.
Hair may be trimmed in the groin area around where the catheter would be placed.
An intravenous line is to be inserted, if necessary, one might receive medication quickly.
The heart is to be monitored, doctors will place electrodes for the same. Pulse oximeter, a small device might be clipped on a finger or ear to track the oxygen level in the blood.
During the procedure
Commonly, these treatments are done with the patient sedated although, not asleep.
Patients are asked to lie on the back on a procedure table. Doctors inject a local anesthetic into the skin, at the site where the catheter will be inserted. Once the anesthetic effect takes on, the catheter is inserted into the blood vessels. The patient might feel some pressure within the artery as the catheter is moved. The patient may ask for necessary additional pain medication, if required.
The contrast dye will be released, once the catheter reaches the heart. The dye aids in making the blockage visible, so that the area where the blood vessel is blocked can be identified. A brief flushing sensation and feeling warm are common signs patients face when the dye is released in the body. Many people experience a salty or metallic taste in the mouth, or a brief headache. It is very rare, when people feel nauseated or even vomit during this procedure. All these effects are harmless and usually last for a few minutes only.
When the narrowing is detected, the catheter will be advanced so the special tip can be activated. There are some possibilities that one can experience some chest pain or discomfort at this point, but the doctors will monitor the patient carefully and the discomfort will end in a while.
Once the doctors are done, they will withdraw the catheter and put some pressure on the insertion site to stop the inner bleeding. This pressure lasts for about 15 minutes after which the insertion site is bandaged.
The patient might need to keep their leg straight for several hours, if the catheter was inserted in the groin. The doctor may ask the patient to keep their arm elevated on pillows, if the catheter was inserted in the arm.
After the procedure
The patient is kept in a recovery room on bedrest for several hours of observation, usually, for the next 6 or 8 hours. Painkillers are given, if required.
Doctors will encourage the patient to drink more water and other fluids, to aid flush the contrast dye from the body.
Many doctors prefer to keep the patient under observation for a night after this procedure.
Complications in PCI are quite rare, but still can take place. Complications might include bleeding, blood vessel damage, a treatable allergic reaction to the contrast dye, an emergency call of a coronary artery bypass grafting during the procedure, arrhythmias, damage arteries, kidney damage, heart attack, stroke, or blood clot. The risk factors increase with the age of the patient. Older patients with medical histories might face other serious complications.