Percutaneous Coronary Interventions - PCI |
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Percutaneous coronary intervention - PCI, encompasses
a variety of procedures used to treat patients with diseased arteries
of the heart, for example, chest pain caused by a build-up of fats,
cholesterol, and other substances from the blood (referred to as plaque)
that can reduce blood flow to a near trickle, or a heart attack caused
by a large blood clot that completely blocks the artery. |
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Angioplasty / Balloon Angioplasty |
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Angioplasty is a procedure that widens a narrow or obstructed
blood vessel using a balloon catheter. It is used to treat atherosclerosis
(blood vessel obstructions), and usually performed by an interventional
cardiologist, a medical doctor with special training in the treatment
of the heart, using invasive catheter-based procedures |
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Angioplasty is commonly performed as a minimally-invasive
(percutaneous) procedure, where a stent (small mesh tube) is inserted
into the blood vessel to keep it open. A possible alternative to heart
surgery, it has consistently been shown to reduce symptoms due to coronary
artery disease and reduce cardiac ischemia. |
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| The Procedure |
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An introducer needle is inserted into the femoral
artery in the leg, sometimes into the radial artery or brachial
artery in the arm. Following this, a sheath introducer is
placed in the opening to keep the artery open and control bleeding
during the procedure. |
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A guide catheter (long, flexible, soft plastic tube) is then pushed through the sheath introducer. Dyes can be injected through the guide catheter into the coronary artery to locate and study the diseased artery using x-ray. |
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After studying the x-ray image, the cardiologist
selects the type of balloon catheter and flexible coronary guide
wire that will be used. The flexible guidewire with radiopaque
plastic tip is then inserted into the guiding catheter and into
the coronary artery. |
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Viewing through x-ray
imaging monitor, the cardiologist guides the flexible coronary
guidewire through the coronary artery to the site of the blockage. |
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When the flexible guidewire
reaches the blockage, it is then pushed across the blockage. |
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A hollow-tipped balloon
catheter is then inserted, using the flexible guidewire as a
pathway to the site of the blockage. At this point, the balloon
is still deflated. |
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After the balloon catheter
reaches and is pushed inside the blockage, the balloon is then
inflated. Inflating the balloon expands the area around it and
compresses the plaque buildup or blockage. The inflated balloon
also expands the artery wall. |
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A stent (wire mesh tube)
sometimes is implanted to keep the artery wall expanded. The
stent initially is inserted along with the balloon catheter,
expands when the balloon is inflated, and left behind in the
expanded position as the balloon catheter is removed. |
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Peter Scott - Team Leader
