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PCI is considered 'non-surgical' as it uses a small hole in a peripheral artery (leg/arm) to gain access to the arterial system; an equivalent surgical procedure would involve the opening of the chest wall to gain access to the heart area. The term 'coronary angioplasty with stent' is synonymous with PCI.
A PCI involves performing a coronary angiogram to determine the location of the infarcting vessel, followed by balloon angioplasty (and frequently deployment of an intracoronary stent) of the stenosed arterial segment. In some settings, an extraction catheter may be used to attempt to aspirate (remove) the thrombus prior to balloon angioplasty.
The vast majority of stents used in modern interventional cardiology are drug-eluting stents (DES). They are used in a medical procedure called percutaneous coronary intervention (PCI). Coronary stents are divided into two broad types: drug-eluting and bare metal stents. As of 2023, drug-eluting stents were used in more than 90% of all PCI ...
The balloon is removed and the stent remains in place, supporting the inner artery walls in the more open, dilated position. Current stents generally cost around $1,000 to 3,000 each (US 2004 dollars), the drug-coated ones being the more expensive.
A stent graft or covered stent is type of vascular stent with a fabric coating that creates a contained tube but is expandable like a bare metal stent. Covered stents are used in endovascular surgical procedures such as endovascular aneurysm repair. Stent grafts are also used to treat stenoses in vascular grafts and fistulas used for hemodialysis.
Balloon catheters are also utilized in the deployment of stents during angioplasty. Balloon catheters are supplied to the cath lab with a stent pre-mounted on the balloon. When the cardiologist inflates the balloon it expands the stent. When the cardiologist subsequently deflates the balloon, the stent stays behind in the artery and the balloon ...
During a balloon angioplasty, the stent is inserted into the artery to provide a "scaffold" to open the artery. An anti-rejection-type medication, sirolimus , helps to limit the overgrowth of normal cells while the artery heals which reduces the chance of re-blockage in the treated area known as restenosis , and reduces the chances that another ...
Rates of restenosis differ between devices (e.g., stent-grafts, balloon angioplasty, etc.) and location of procedure (i.e., centrally located in the heart, such as the coronary artery, or in peripheral vessels such as the popliteal artery in the leg, the pudendal artery in the pelvis, or the carotid artery in the neck). [citation needed]