Percutaneous coronary intervention (PCI)
A procedure that consists of a balloon intervention and/or implantation of a stent into the coronary artery. The procedure continues to diagnostic coronary angiography when it is necessary to repair a narrowed or closed coronary artery. Depending on the extent and position of the coronary disease, several stents can be implanted. Stents are endovascular prostheses (metal supports) that are implanted into the heart artery to keep it maximum opened. There are older stents generations that are not covered with the drug (bare metal stent, or BMS) and newer stents generations that carry the drug and significantly reduce the ability to close the artery (“drug-eluting stent” or DES). In our lab, all the stents are the latest generation DESs.
Why would you need the procedure?
The primary indications for the procedure are the treatment of angina (stable or unstable), acute myocardial infarction, and “silent” cardiac muscle ischemia, which are typical for patients with diabetes. Such patients do not have chest pain but an intolerance of exertion, shortness of breath, or frequent heart rhythm disorders.
What does the procedure include?
The intervention is a follow-up to diagnostic coronary angiography and can be performed in the same act in the case of emergency patients and in patients who have a high-grade, sub-occlusive narrowing (narrowing over 90%) or more often in another act (second hospitalization) after adequate medical preparation of the patient. During the 30-60 minutes lasting procedure, the narrowing of the coronary arteries are restored with wires, balloons and stents. Arteries that are up to a few millimeters in diameter can be expanded with a miniature balloon, but for the long-term maintenance of their patency, an endovascular support (stent) is implanted.
How to get prepared?
It is necessary to be on empty stomach and with a shaved groin. Bring your complete medical records, daily drug therapy, and personal hygiene accessories. In the case of interventions on the coronary arteries, the patient stays in the hospital one day, and in the case of diagnostic coronary angiography, is discharged home the same day. Prior to hospitalization, basic laboratory tests should be performed on an outpatient basis: blood type, CBC, CRP, K, Na, urea, creatinine, bilirubin, AST, ALT, GGT, glucose, total cholesterol, HDL, LDL, triglycerides, PT or INR, APTT. These findings should not be older than 14 days. Persons suffering from diabetes or chronic renal failure should have increased hydration for several days before the procedure. If you are taking medicines that prevent blood clotting (Martefarin, Pradaxa, Eliquis, Xarelto, etc.), you should notify the interventional cardiologist one week before the scheduled surgery to agree about the time of discontinuation of therapy. In case of acute inflammatory events (pneumonia, urinary tract inflammation, influenza, etc.) or in case of an allergy to iodine contrast, the interventional cardiologist should be informed on time.