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Percutaneous coronary intervention (PCI) is a minimally invasive non-surgical procedure used to treat narrowing of the coronary arteries of the heart found in coronary artery disease. [2] The procedure is used to place and deploy coronary stents , a permanent wire-meshed tube, to open narrowed coronary arteries.
Various techniques of pain management and anesthesia are practiced during current PCI stent placement procedures. [7] The catheter/stent system is introduced into the body by penetrating a peripheral artery (an artery located in the arm or leg) and passed through the arterial system to deliver the DES into the blocked coronary artery.
Surgeries performed may be minimally-invasive endovascular procedures such as a percutaneous coronary intervention (PCI), which involves coronary angioplasty. The angioplasty uses the insertion of a balloon and/or stents to open up the artery. [1] Other surgeries performed are the more invasive bypass surgeries that graft arteries around blockages.
For coronary artery disease (ischemic heart disease), coronary artery bypass surgery and percutaneous coronary intervention (coronary balloon angioplasty) are the two primary means of revascularization. [2] When those cannot be done, transmyocardial revascularization or percutaneous myocardial revascularization, done with a laser, may be an option.
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.
PPS can also be caused after a trauma, a puncture of the cardiac or pleural structures (such as a bullet or stab wound), after percutaneous coronary intervention (such as stent placement after a myocardial infarction or heart attack), or due to pacemaker or pacemaker wire placement. [1]
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]
Primary percutaneous coronary intervention (PCI) is the treatment of choice for STEMI if it can be performed in a timely manner, ideally within 90–120 minutes of contact with a medical provider. [ 72 ] [ 124 ] Some recommend it is also done in NSTEMI within 1–3 days, particularly when considered high-risk. [ 72 ]