Percutaneous Coronary Intervention

Balloon Angioplasty

Percutaneous coronary intervention (angioplasty) surgery is performed in the cardiac catheterization laboratory. The angioplasty procedure usually consists of most of the following steps:

  1. Disinfect the skin where the catheters are to be inserted, either groin or wrist, and then inject a local anesthetic (numbing medicine) where the catheters will be inserted.
  2. A small incision is made in the femoral artery or radial artery with a special needle so that a guiding catheter (long, flexible tube) can be inserted and advanced through the aorta to where the coronary arteries branch off to the heart.
  3. Inject the contrast medium through the guiding catheter so that the location and the size of the narrowing can be assessed.
  4. Advance the balloon catheter over a long and extremely thin wire, called guidewire, into and through the guiding catheter to the lesion.
  5. Inject the contrast medium into the balloon, and then the balloon is inflated and it stretches the narrowed artery.

The following is the simplified steps of balloon angioplasty,

1. Balloon catheter is advanced through the site of arterial stenosis
2. Balloon catheter is dilated at lesion site to open up channel for blood circulation.
3. Balloon catheter is deflated and withdrawn.

Coronary Stenting

After balloon angioplasty, implantation of metal stent should be done within a short period of time (several months) at the lesion to reduce the acute restenosis or re-occlusion. The stenting procedure is similar to the balloon angioplasty procedure:

1. Long and thin steel wire is inserted, and the balloon catheter with a coronary stent (mounted on the balloon) is delivered to the lesion.
2. Contract dye is introduced into the balloon, distention of the balloon will allow the stent to expand
3. The stent is positioned at lesion site and deployed to provide scaffolding to the arterial wall. This ensures the artery remains open and will prevent future narrowing or blockage of the artery.

The following is the simplified steps of stenting:

  1. Artery remains narrow after coronary angioplasty
  2. Stent pre-mounted on balloon catheter is then delivered to lesion site and deployed.
  3. Balloon catheter is withdrawn and the stent remains in the artery permanently.

After Procedure

Suggestions on Life Style

Patients are recommended to adopt healthier lifestyle and habits, some of which include the following:

  • Minimize intake of food containing high fat, cholesterol and salt
  • Prohibited from smoking.
  • Reduce stress
  • Maintain regular exercises

Suggestions from Doctors

  • Patients must promptly follow medication prescription and not stop medication prematurely
  • Patient should seek advice from physician prior to stopping any prescribed medication
  • Patients should inform doctor immediately if experiencing side effects from any medication, including chest pain and chest discomfort
  • Patients should be prompt on follow-up visit(s)