CORONARY ANGIOPLASTY & STENTING(PCI)
PCI is an interventional treatment used to widen critically narrow coronary arteries .These are blood vessels which supply oxygenated blood to the heart and are three in number.
During PCI the narrowed portion of the coronary artery is crossed with a very thin guide wire & the blockage is dilated with a widened balloon sent over the wire .Finally a metallic stent is left inside the artery at the site of blockage to keep it open.
WHAT IS CORONARY ANGIOPLASTY & STENTING(PCI)
PCI is a minimally invasive procedure to treat critically blocked coronary arteries that are responsible for symptoms or signs of ischemia (lack of blood supply).
The exact identification of the location and extent of blockage is done by coronary angiography.
During PCI the critical narrowed part of the coronary artery is treated by dilating(widening) the passage by using a small balloon & keep it open by using a stent. A stent is small metallic tube which is laser cut to give it flexible and is placed across narrowed portion to keep it open permanently.
WHO NEEDS CORONARY ANGIOPLASTY & STENTING(PCI)
People who have symptom or signs of ischemia (lack of blood supply) to the heart,such as those experiencing heart attacks,those who have chest discomfort on excertion(angina) or those who have proven ischemia by earlier testing such as stress testing (Treadmill or Nuclear Scan).Such Patients would have undergone coronary angiography to identify a portion of a coronary artery that is critically narrowed (70% or more) are recommended to undergo PCI.
HOW IS CORONARY ANGIOPLASTY & STENTING (PCI) DONE ?
You will be asked to avoid eating or drinking 3-4 hrs before the test.First the doctor will place a sheath in the groin or arm vessel i.e.Femoral or Radial artery ,after giving local anaesthetic to numb the area.
Through the sheath a guide wire and a guide catheter are place in the mouth of the concerned coronary artery.The blockage is crossed with a very thin (0.014)guide wire following which it is widened using a balloon and then kept open by a coronary stent which is left permanently across the blockage to keep vessel open.
The procedure lasts usually for one hour to two hours.After the procedure the patient will be closely monitored in the ICCU for 24 hours.The grojn/arm catheters are remove after e few hours as the procedure involves administration of blood thinners.The patient has lie flat and avoid movement of the limb to reduce chances of bleeding .
WHAT ARE THE RTISKS OF PCI ?
Although a safe procedure ,as the procedure involves the arteries supplying blood to the heart ,there are certain risks,which include arrhythmias (abnormal heart beat),heart attack,bleeding,low blood pressure,Allergic reaction to contrast dye,Blood clots,Strokes ,Injuries to blood vessels, Acut clotting of the stent (stent thrombosis),Chest pain,Kidney failures and very rare to Death.All these are rare risk & your doctor and hospital are well trained and equipped to prevent and treat them.
DO’S & DON’Ts IN MANAGING CORONARY ANGIOPLASTY AND STENTING (PCI)
1 Do understand the risks.Talk to your doctor about the treatment procedure.
2 Do take your medicine as prescribed.After a stent has been placed it is very very important to take dual antiplatelet drugs to prevent late stent thrombosis(clot developing in stent)for as long as advised by doctor.
3 Be heart healthy :control your diabetes and blood pressure and cholesterol levels by regular checking.Loose weight if overweight.Exercise regularly once declared by your doctor to do so.Adopt and maintain a low fat diet.
4 Be regular in follow-up with your doctor and keep him apprised of any untoward symptoms.
5 Do not stop any medication on the advice of anyone else apart from your doctor including other doctors who may not be aware of the risk involved.