Percutaneous coronary intervention — commonly known as angioplasty and stenting — is a catheter-based procedure to open blocked coronary arteries and restore blood flow to the heart muscle without open-heart surgery.
PCI is performed by an interventional cardiologist in the cardiac catheterization laboratory. A thin, flexible catheter is inserted through an artery — most often the radial artery at the wrist — and guided to the blocked coronary artery using X-ray imaging (fluoroscopy). A wire is passed across the blockage, a small balloon is inflated to compress the plaque against the artery wall, and a stent (a small expandable metal mesh tube) is deployed to hold the artery open.
Modern stents are drug-eluting stents (DES), coated with medication that prevents the artery from re-narrowing (restenosis). These have dramatically improved long-term outcomes compared to older bare-metal stents.
During an ST-elevation myocardial infarction (STEMI), a coronary artery is completely blocked by a blood clot. Emergent PCI — also called primary PCI — is the most effective treatment, rapidly restoring blood flow and limiting damage to the heart muscle. Time is critical: guidelines emphasize a door-to-balloon time of less than 90 minutes.
For patients with stable coronary artery disease and significant blockages causing symptoms (angina) despite optimal medical therapy, elective PCI can relieve symptoms and improve quality of life. The decision to proceed is based on the severity and location of blockages, symptoms, and stress testing results.
Most PCI procedures today are performed through the wrist (radial artery) rather than the groin (femoral artery). Radial access is associated with less bleeding, earlier mobilization, and greater patient comfort. Dr. Pinto routinely performs complex coronary and peripheral interventions via radial access.
PCI is typically performed under conscious sedation (you are awake but comfortable). The procedure usually takes 30 minutes to 2 hours depending on complexity. Most patients go home the same day or after one night in the hospital. You can usually return to normal activities within a few days, though heavy lifting should be avoided for a short period after the procedure.
After stent placement, patients must take dual antiplatelet therapy — typically aspirin plus a second antiplatelet medication (such as clopidogrel, ticagrelor, or prasugrel) — for a period defined by your cardiologist (usually 6–12 months). This prevents blood clots from forming inside the new stent. Stopping these medications early can be dangerous and should never be done without consulting your cardiologist.
Long-term medications also include statins, blood pressure medications, and other agents to manage the underlying coronary artery disease.
PCI is generally very safe, but risks include bleeding at the access site, coronary artery dissection (a tear in the vessel wall), restenosis (re-narrowing of the stent), stent thrombosis (blood clot in the stent — rare but serious), contrast dye–related kidney injury, and, rarely, heart attack or stroke during the procedure.