The Technique of the Procedure
Percutaneous coronary intervention which is also called PTCA (percutaneous transluminal coronary angioplasty) is a catheter-based procedure. The procedure involving cardiac catheterization is performed during an angiogram in the angiography suite (operating room equipped with radiological and screening equipment). PCI is performed by an interventional cardiologist and takes 30 minutes to 3 hours according to the doctor’s experience and complications he may encounter. Patients undergoing PCI are usually awake but don’t feel pain during the procedure because of the sedative and the local anesthesia applied at the site of access.
Percutaneous coronary intervention (PCI) is typically performed through the femoral or radial arteries and less commonly through the brachial or ulnar arteries. Overall, the radial artery has become the most frequent route of access for cardiac catheterization procedures because it could be more easily compressed against the radial bone when compared to the femoral artery. However, due to its small size, access to the radial artery requires greater experience and competency. After making a tiny incision, a catheter (long hollow tube) will be inserted into the blood vessel.
When the catheter reaches the aorta, a contrast dye will be injected into the coronaries. With x-ray fluoroscopy, the contrast dye helps visualize the site of stenosis in the coronaries and assess its severity. After locating the stenotic area, an expandable balloon at the tip of the catheter will be introduced there. Then the balloon will be inflated which will restore the arterial patency and stretch the stent over it. Finally, the balloon is deflated, and the catheter will be withdrawn leaving a stent at the site of stenosis to prevent recurrence. After removing the catheter, bandages will be applied at the site of the incision and the patient will have to stay in a recovery room for a few hours to be observed.