Coronary Angioplasty (PCI)
In the past, women didn’t receive PCI until they were older and sicker than men. However, at Brigham and Women’s we recognize that women do equally well when treated earlier. We recognize the early signs of coronary artery desease in women and offer PCI when it’s appropriate.
What to Expect:
- It’s important to follow the prep instructions carefully.
- The procedure is painless.
- The dye may leave a metallic taste in your mouth.
- Sedatives will help you lie very still.
- You may be able to go home the following day.
Coronary angioplasty, or percutaneous coronary intervention (PCI), is used to open blockages in the coronary arteries by inflating a small balloon to flatten the obstruction and usually by adding a small mesh tube, or stent, to keep the artery open. It may be performed if you are having chest pain or a heart attack. Angioplasty is done in conjunction with coronary angiography, which enables the doctors to determine whether they have reduced the blockage in the artery.
Preparing for Angioplasty
An angioplasty is performed in conjunction with coronary angiography and may be done on the spot when a diagnostic angiogram indicates a coronary artery blockage.
A few days before your angioplasty is scheduled, you will visit the hospital for blood tests, a chest x-ray and an electrocardiogram, all of which will give your doctors and technicians information to help them plan your procedure. A nurse or technician will also explain the risks of the procedure and give you a consent form to sign. Even if you are scheduled only to undergo angiography, you may also be asked to sign a consent form to have an angioplasty in case the angiogram indicates a blockage. You will be asked not to eat or drink anything for eight hours before your catheterization.
When you arrive at the hospital, you will be given an identification bracelet and a hospital gown to wear during the procedure. A technician will ask you a few questions and may take your blood pressure. The staff will take you into a catheterization laboratory or “cath lab” and help you onto the examination table. You’ll be greeted by the doctor who is performing your procedure and the staff who will be assisting. One of the staff will place electrodes on your chest, which will be connected to the machine that will monitor your heart function. An attendant will insert a needle connected to a flexible tube, or IV line, into your arm and will use an antiseptic to cleanse an area of your groin or arm where the catheter will be inserted. You’ll be given a mild sedative through the IV line. You may feel a little drowsy and may even drift in and out of sleep. The staff will inject a local anesthetic into the skin where the incision will be made. It may sting.
Once the area is numb, the doctor will make a small incision to locate the vein. He or she will then insert the catheter into the vein and guide it into your heart. After the catheter is in place, the team may perform several types of measurements, including the blood flow and internal pressures of your heart or an assessment of your heart valve function, and will infuse a radioactive dye, or contrast agent, into it. You may feel a slight warmth or burning sensation as the dye is injected. The dye travels to the heart and coronary arteries and several x-rays are made.
If the angiogram indicates a blockage, doctors will thread a balloon-tipped catheter up to the plaque and will inflate the balloon, pressing the plaque against the vessel walls. They will likely follow with a second catheter bearing a stent that they will place in the artery at the site of the blockage to hold the vessel walls open. If you have chest pain or are experiencing a heart attack, you may feel relief as blood flow to the heart is restored.
When the doctor has completed the procedure, the team will remove the catheters, the IV line and the electrodes connecting to the heart monitor. They will put a pressure bandage on the area where the catheter was inserted, and a small bandage on your arm where the IV has been. You will be helped onto a comfortable, bed-like gurney and wheeled into a recovery room. There, nurses will watch over you, taking your heart rate and blood pressure from time to time, until the sedative has worn off. Once you are fully alert, you will be taken to a hospital room to further recover. You can expect to go home within a day or two. Before you leave the hospital, you’ll be given detailed instructions for caring for yourself.
Date Last Modified: January 21, 2011
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