Percutaneous Coronary Interventions (PCI)

Percutaneous coronary intervention (PCI)
(PCI) is a term that describes a group of procedures performed by interventional cardiologists in the cardiac catheterization laboratory (the “Cath Lab”) to treat coronary artery disease. Percutaneous means that the procedure is performed through the skin (it is relatively non-invasive) into a series of arteries. Coronary refers to the location of the procedure – the heart’s coronary arteries. An intervention is a procedure that is intended to correct a problem or pathological process. Coronary artery disease may produce chest pain, atherosclerosis, a heart attack, or a large blood clot.

The Procedure
PCI is typically performed by inserting a needle into the large femoral artery in the groin; threading a guide wire up through the groin artery, abdominal aorta, thoracic aorta, and into the diseased coronary artery of the heart; threading a catheter around the guide wire and following it up into the targeted coronary artery; and, finally, repairing the damage. Angiography imaging is used during the procedure to allow the cardiologist to view the anatomy and the catheterization equipment. A diagnostic cardiac catheterization procedure can lead to an immediate PCI if treatable coronary artery disease is discovered. PCI procedures include:

Angioplasty
Atherectomy
Stenting

Heart Attack Patients
The goal of the American Heart Association and its collaborating organizations is to restore blood flow to the heart muscle within 90 minutes of the patient’s arrival at the hospital. PCI performed in an emergency situation is referred to as “primary” PCI. Other PCI procedures are “elective.”

American Heart Association PCI Guidelines
The American Heart Association suggests the following guidelines for the management of patients undergoing PCI:
• PCI should be performed in facilities that have an experienced cardiovascular surgical team on site and available as an emergency backup for all procedures.
• Early follow-up should be conducted on patients who have PCI of the left main coronary artery.
• A heart hospital should have strategies for ensuring the best possible patient outcomes and for monitoring quality of care.
• Heart hospitals and their physicians should prove ongoing competency, including quality assurance and institutional and physician volume of procedures performed.


Resources

American Heart Association www.americanheart.org/presenter.jhtml?identifier=4454