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Coronary Angioplasty and Stenting (PCI)

prof. Usman Jafferprof. Usman Jaffer

Coronary angioplasty and stenting (also known as PCI) is a minimally invasive procedure and almost always performed with the patient awake under local anaesthesia.The procedure is performed in a cardiac catheterisation room by your interventional cardiology team.

A cardiac team performing a procedure. The patient is lying on a table. The x ray machine is being used to guide the procedure. The images produced are displayed on a TV screen.

You will lie on a table in the cardiac catheterisation room and the doctor will inject local anaesthesia around the blood vessel in the arm or leg. 

The arteries supplying the muscle to the heart can be accessed from the arteries at the wrist or the arteries in the groin.

Following this a thin, flexible tube (catheter) is inserted into the blood vessel in either your arm or leg; this allows the catheter to be inserted into the heart's (coronary) arteries. 

Showing a 'catheter' being inserted from the right groin up the body to the heart.

During the procedure the interventional team will be monitoring your heart beat and blood pressure.The doctor gently pushes the catheter up the coronary arteries and gently manipulates it into the correct position. Low-dose X-rays and contrast (dye) are used to monitor the progress of the procedure. A thinner balloon is then passed down the catheter to the area of the coronary artery that has narrowing. 

Narrowing in heart arteries demonstrated. The balloon and stent combination shown squeezes the narrowed area open and holds it open with a scaffold (stent)

The balloon is blown up for seconds, this widens the narrowed artery by pushing the fatty material out of the path of the blood. A stent is left in the coronary artery within the widened section. The stent is metal meshwork which supports the coronary artery and helps keep the artery widened. When the balloon or stent is blown up it temporarily stops the blood flow. Therefore, you may have an angina-like pain for a short time. However, this soon resolves after the balloon is let down.

At the end of the procedure your doctor will remove the catheter from the coronary artery and the plastic tube in your arm or leg. You will then remain in hospital to recover and be monitored for roughly 4 hours.

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