Coronary artery disease — or CAD — is a heart disease that’s often treated with medications as well as lifestyle and dietary changes. If your condition worsens, your doctor might suggest percutaneous coronary intervention — PCI, for short — to help your arteries.
Percutaneous coronary intervention is the general name for procedures that open up blocked coronary arteries, blood vessels that supply oxygen via blood to your heart muscles.
Sometimes plaque -- fatty substances like cholesterol -- builds up in these arteries, making them stiff and narrow, which restricts blood flow and leads to CAD. Poor blood flow to your heart can cause heart damage, chest pain, shortness of breath, tiredness, and an increased risk of getting a heart attack. Your heart can also weaken over time, which can lead to heart failure.
Percutaneous coronary intervention can treat and reduce symptoms of CAD like chest pain. It can also limit damage to the heart during or after a heart attack.
What Are the Types of Percutaneous Coronary Intervention?
The main goal of PCI is to open up clogged arteries, but there are different ways your doctor can do that. PCI types include:
- Balloon angioplasty. A balloon is inserted and inflated in your artery to press plaque out of the way.
- Laser angioplasty. A laser is inserted on the end of a catheter and vaporizes plaque.
- Rotational atherectomy. A special drill is inserted into the artery to remove calcium deposits.
- Angioplasty with a stent. A balloon is used to open the artery and a permanent metal coil is placed to help keep the artery open.
- Impella-supported PCI. A tiny pump is inserted into your heart through your skin to help your heart pump blood.
How Are Percutaneous Coronary Intervention Procedures Done?
Percutaneous coronary intervention procedures vary depending on the type. In most cases, you’ll be awake for the procedure, though you’ll be given a sedative to help you relax.
Your doctor will make an incision in your arm or groin and insert a small, thin tube called a catheter into your blood vessel. Depending on the type of procedure, there may be a balloon, laser, or drill at the end of the catheter. By using special dyes and X-ray scans, your doctor will guide the catheter toward your coronary artery.
Once they reach the blockage, they will inflate the balloon until it presses the plaque against your artery walls and opens your blood flow. During an atherectomy or laser angioplasty, your doctor uses a drill or laser to remove the plaque. If you’re getting a stent in the heart, they’ll place it against your artery walls for support and to help keep your artery open.
Once the procedure is finished, your doctor will remove the catheter. Many people can go home the same day, but your doctor might keep you overnight at the hospital for monitoring. If you go home, you’ll need to have someone drive you. You might also need to take new medications after your procedure.
What Are the Risks of a Percutaneous Coronary Intervention Procedure?
Most people don’t have any serious complications from PCI, but they can happen. Some possible risks are:
- Blood vessel damage from the catheter
- Allergic reaction to the dye
- Kidney problems from the dye
- Heart attack
- Blood clot
- Artery damage
- Irregular heart rhythm
- Chest pain
You might have a higher risk of complications if you’re older, you’re having heart failure at the time of the procedure, you have lots of blockages, or you have chronic kidney disease.
In some cases, restenosis happens after the procedure. This usually happens when tissue grows back around a stent, causing your artery to become blocked again. If this happens, you’ll need to have the procedure done again.
If you don’t feel well after the procedure, make sure you talk to your doctor.