Percutaneous coronary intervention (PCI) is a minimally-invasive procedure that uses a thin, flexible tube called a catheter to place a stent into an artery that is narrowed by plaque buildup (a process called atherosclerosis). A stent is a small, drug-coated, metal mesh that pushes away plaque to open the artery and restore blood flow. During a PCI, the catheter is placed into an artery in the wrist or groin and threaded to the area where the stent is to be placed. An interventional cardiologist uses x-ray to see the artery and feed the closed stent through a catheter. When the stent is in place, a small balloon inflates to open it up, pushing away the plaque and allowing blood to flow freely again. Once the stent is set, the balloon is deflated and removed. The catheter is also removed.
PCI is typically an outpatient procedure done under moderate sedation. Patients prepare for the procedure and recover in our Cardiac Radial Lounge, and can generally go home the same day. Most patients who have a PCI experience minimal discomfort and are able to return to normal activity within a few days.
Chronic Total Occlusion Percutaneous Coronary Intervention (CTO PCI)
A percutaneous coronary intervention for chronic total occlusion (CTO PCI) treats patients who have a 100% blockage in one of their coronary arteries. This severe plaque buildup occurs over time in a condition called atherosclerosis. About 10-15% of patients with coronary artery blockages have 100% blocked arteries. CTO PCI is a complex procedure that is performed by only 1-2% of interventional cardiologists in the US. Often patients are advised to undergo open heart bypass surgery or are treated with medications alone. Left untreated, the blockage may cause significant chest discomfort, shortness of breath, lower quality of life, and potentially decrease heart function.
CTO PCI is a complex procedure that utilizes similar catheters through the wrist or groin artery. It differs from routine PCI in that, often, two catheters are placed in two different locations. In addition, specialized equipment is used to get through, or around your body’s small bypasses to get the blockage open. This procedure take an average of three-four hours and patients are typically monitored overnight in the hospital.
CTO PCI is an evolving field within Interventional Cardiology. In the United States, only a small number of centers have teams trained to perform the full spectrum of techniques to maximize success rate. The Interventional Cardiology team at CMC’s New England Heart & Vascular Institute is pleased to offer this option to patients with coronary artery disease.