Percutaneous coronary intervention (PCI)

Percutaneous coronary intervention, also called coronary angioplasty and stenting, is a specialised treatment to stretch the coronary artery and so reduce or unblock narrowed arteries.

This procedure involves inserting a fine plastic tube (referred to as a sheath) into an artery through a small puncture hole in the groin (preferably) or wrist. The sheath is very narrow – approximately 3mm wide.

A fine tube called a guide catheter is threaded up through the sheath to the heart and positioned at the beginning of the coronary artery. A fine 'balloon catheter' is then threaded through the guide catheter into the narrowed part of the artery. The stent – a thin metal frame or tube – is mounted on the balloon catheter.

Once the balloon catheter is in place, it is inflated. This causes the stent to expand and be pressed up against the wall of the artery. The balloon is then deflated and removed, leaving the stent in place to keep the artery open. More than one stent may be needed to gradually widen the narrowing and achieve a satisfactory result.

After the procedure, the artery is wider, which improves the blood flow to the heart. The stent stays in place and cannot move or be removed.

Above image shows how a stent is inserted

After a stent has been inserted, a thin film of cells grows over and lines the surface. This process takes up to six months, depending on the type of stent used. Until this time there is a risk of blood clotting on the surface of the stent and so blocking the coronary artery. This would cause chest pain and put you at risk of a heart attack. This risk can be significantly reduced by taking medicines such as aspirin and clopidogrel.