Restoring blood flow to the heart with a PCI and stent

3-minute read

If you've had a recent heart attack or ongoing chest pain, a percutaneous coronary intervention (PCI) may help improve blood flow and decrease your risk for future heart issues. PCI is a non-surgical procedure to clear out or widen coronary arteries, the blood vessels that deliver blood to the heart muscle.

A PCI is also called an angioplasty, balloon angioplasty, or coronary artery balloon dilation. In many cases, a stent is placed in the artery during the procedure to help hold the blood vessel open long-term. If your provider has recommended a PCI stent, here's what you need to know.

Why you may need a PCI and/or stent

Coronary artery disease (CAD), the most common type of heart disease, is often the cause of blocked arteries. This condition occurs when fat and cholesterol deposits called plaque build up inside blood vessels. When this happens, it's more difficult for blood to circulate in the body. A buildup of plaque also increases the risk of cardiac events, such as a heart attack or stroke. In many cases, CAD does not cause any symptoms until it causes a heart attack.

PCI is one way to treat narrowed or blocked arteries due to CAD. Your provider may recommend PCI:

• During or after a heart attack
• For treatment or management of heart failure or poor heart functioning
• If you have angina or frequent chest discomfort or pain that's difficult to control with medication
  
• To improve your ability to participate in physical activity without chest pain or other heart-related issuesIn some cases, clearing out or widening an artery with PCI may not be enough. If plaque blocks 70% or more of your blood vessel, a stent is often recommended. Stents help hold the artery open and lower your risk of a future heart attack or stroke.

The three main types of PCI stents include:

• Bare metal stents — a wire mesh tube
• Biodegradable stents — a temporary stent that dissolves into the body over time
• Drug-eluting stents — a stent coated with medication that is released over time to help keep the artery open

The procedure is the same, no matter what type of stent you get.

What to expect when you have a PCI with stent placement

Interventional cardiologists usually perform angioplasties or PCIs. These specialists use catheters, which are small flexible tubes, and imaging technology to treat heart conditions.

Before the procedure, the area where the catheter will be inserted is numbed. You'll take medication to help you relax or decrease pain. In most cases, you will be awake throughout the procedure.

During a PCI, the interventional cardiologist threads the catheter into the artery with a thin needle. The catheter may be inserted through your arm, wrist, or upper leg near the groin. Once the catheter is in place, the interventional cardiologist uses real-time X-rays to guide it through the body into the coronary artery. Sometimes, the contrast dye is placed into the blood vessels to help the cardiologist get a clearer image of blood flow and blockages in the blood vessels.

Catheters used for PCIs have a balloon attached to the end of the tube. When the catheter is in place, the balloon is inflated to widen the artery so that blood can move through it freely. In an angioplasty with stent, the stent is placed around the balloon before it is threaded into the body. When the balloon inflates, the stent also presses outward into position. Once the stent is in place, the balloon is deflated and removed, leaving the stent behind and restoring blood flow to the heart. The procedure takes approximately 30 minutes.

After the procedure

Most patients do not have much pain during or after the procedure. However, it is common to have some bruising and soreness at the catheter site. You may need to stay in the hospital overnight.

After the procedure, your provider will prescribe an anti-platelet drug. This medication helps prevent blood clots. You will likely stay on this medication for at least one month.

Because stents are placed without traditional surgical incisions, recovery time is typically much faster and easier than recovery from surgery. You'll need to avoid strenuous activities or heavy lifting for about two days after the procedure. Typically, you can return to your usual routine and work schedule within a week.

Your cardiologist may recommend cardiac rehab depending on why you received the PCI stents, your overall health, and personal risk factors. Cardiac rehab is an outpatient program that can help you improve your overall heart health and lower your risk of future heart issues.

Make an appointment with a Reid Heart & Vascular Center expert to learn more about percutaneous coronary intervention, PCI stents, and how to keep your heart healthy.