What is PCI?1
Percutaneous coronary intervention (PCI) is a procedure used to open blocked heart arteries. Arteries can become clogged by a buildup of fat, calcium, or other deposits known as plaque that occur with coronary artery disease. In PCI, a tiny balloon catheter is inserted in a blocked blood vessel to help widen it and improve blood flow to the heart, often followed by the placement of a small wire mesh tube called a stent. The stent helps prop the artery open, decreasing its chance of narrowing again.
This procedure can improve symptoms of blocked arteries, such as chest pain and shortness of breath. It may be a treatment option for you if:1
- You have tried medications or lifestyle changes but these have not improved your heart health.
- You have chest pain (angina) that is worsening.
- You have a heart attack. Angioplasty can quickly open a blocked artery, reducing damage to your heart.
What’s involved in PCI?1
The procedure is performed through an artery in your groin, arm or wrist area. General anesthesia isn’t needed. You’ll receive a sedative and local anesthesia to help you relax, but you may be awake during the procedure, depending on how deeply you are sedated.
- A small balloon with a stent at the tip of the catheter is threaded into the artery and inflated at the site of the blockage. The stent is expanded and locks into place inside the artery.
- After the stent is placed in the artery, the balloon is deflated and the catheter is removed.
- The stent stays in the artery permanently. In some cases, more than one stent may be needed to open a blockage.
- If you have several blockages, the procedure may be repeated at each blockage.
Most stents implanted during PCI today are drug coated. The medication in the stent is slowly released to help prevent future plaque buildup and re-narrowing of the blood vessel.
PCI greatly increases blood flow through the previously narrowed or blocked coronary artery. Chest pain generally should decrease. You may be better able to exercise and resume the daily activities of your life with family and friends.
After your stent placement, your doctor will prescribe medications to reduce the chance of blood clots forming. It is important that you follow your doctor’s directions on medications. Do not stop taking medication unless directed to do so by your cardiologist.
Having a stent implanted doesn’t mean your heart disease goes away. You’ll need to continue healthy lifestyle habits and take medications as prescribed by your doctor in order to slow or prevent plaque rebuilding in your artery.
If you have symptoms similar to those you had before PCI, such as chest pain or shortness of breath, contact your doctor. If you have chest pain at rest or pain that doesn’t respond to nitroglycerin, call 911 or emergency medical help.
Successful PCI may mean that you might not have to undergo coronary artery bypass surgery, a more invasive procedure that requires a longer recovery time.
Are there alternatives to stents?
Drug-eluting stents have been around for almost 20 years. They have been shown to be very effective at reopening arteries that have been clogged. However, after 10 years with a stent, almost half of patients are at risk for serious health issues,2 including a follow-up heart attack, more hospital stays, replacement stents, and even death.
The DynamX Bioadaptor is the newest advancement in treating blocked arteries. It is implanted just like a stent, but unlike a stent that constrains and “cages” an artery, it allows your artery to move and function more naturally in response to your heart’s needs.3 Natural artery motion and expansion are intended to keep the heart healthy. The DynamX Bioadaptor has unique flexible joints that allow it to expand, contract and twist along with the artery.3 It can move in response to the body’s need for blood flow during activity, and also in response to prescription medications that dilate the vessels.4
Coronary arteries have the natural ability to accommodate blockages or plaque by expanding to a certain extent to keep blood flowing. Unlike stents, the DynamX Bioadaptor also allows arteries to naturally expand to a certain extent, and stay open in order to maintain good blood flow – even when plaque begins to build up – which happens as coronary artery disease progresses.3
The DynamX Bioadaptor is designed to improve long-term outcomes for patients, and reduce the frequency of the critical health risks associated with stents.
If PCI isn’t appropriate for you
PCI isn’t for everyone. Depending on the extent of your heart disease and your overall health, your doctor may determine that coronary artery bypass surgery is a better option than PCI for you.
In coronary artery bypass surgery, the blocked part of your artery is bypassed using a healthy blood vessel from another part of your body.
Treating blocked arteries with PCI has become a common procedure today. Learn more about new innovations in PCI to treat coronary artery disease.
- Coronary angioplasty and stents. Mayo Clinic. Accessed online November 12, 2021. https://www.mayoclinic.org/tests-procedures/coronary-angioplasty/about/pac-20384761
- Kufner S, Joner M, Thannheimer A, Hoppmann P, Ibrahim T, Mayer K, et al. Ten-year clinical outcomes from a trial of three limus-eluting stents with different polymer coatings in patients with coronary artery disease: results from the ISAR-TEST 4 randomized trial. Circulation. 2019; 139:325–333. doi: 10.1161/CIRCULATIONAHA.118.038065.
- Verheye S, Vrolix M, Montorfano M, Zivelonghi C, Giannini F, Bedogni F, et al. Twelve-month clinical and imaging outcomes of the uncaging coronary DynamX bioadaptor. EuroIntervention 2020;16;e974-e981
- Verheye S. DynamX Bioadaptor, a novel “uncaging” platform for coronary artery revascularization – 24 month clinical results. Poster presented at the annual meeting of the American College of Cardiology; May 25, 2021; New Orleans, LA.