What is the role of Percutaneous Coronary Intervention (PCI)

Percutaneous coronary intervention (PCI) is very commonly known as coronary angioplasty. It is a nonsurgical technique for treating obstructive coronary artery disease. This is useful for treating unstable angina, acute myocardial infarction (MI) and multivessel coronary artery disease (CAD).

Myocardial infarction is also known as heart attack and it may happen when there is less supply of oxygen than required to the heart. The main reason for this is coronary artery occlusion. MI will be diagnosed by at least two of the three mentioned below.
1. prolonged ischemic-type chest discomfort
2. serial ECG changes
3. Higher cardiac markers in serum

PCI will improve blood flow and hence there will be a decrease in heart-related chest pain. Many people get significantly better. They can do more than they could before the procedure.PCI can increase your chances of surviving more than clot-busting medication, PCI will reduce the chances of having another heart attack in the future.
PCI is generally performed in people aged 65 or older.

The procedure doesn't require any major incisions in the body. it is safe to be carried in most people. There is no risk of serious complications in this procedure. But the success of this treatment depends very much on the age of the patient, the general health condition of the patient and earlier heart attacks.

Percutaneous Coronary Intervention (PCI) is actually the procedure of coronary angioplasty which is usually carried out by the doctors to widen the narrowed coronary arteries (the main blood vessels supplying the heart). If these blood vessels are blocked or narrowed down then this procedure gives relief in the patients suffering from this problem, which is actually a major cause of heart attacks.

In this procedure, generally a small wire-mesh tubular type item called stent is inserted in the blood vessel at the place where it is maximum narrowed and then is kept there itself through the ballooning angioplasty method. The thin wire equipment which is used to push this stent to that place is taken out of the body through the same path and stent remains there forever. Sometimes more number of stents can also be placed depending upon the situation. Due to presence of the stent the passage is now relatively wider and the blood can flow easily. The procedure is done under local anaesthesia and the patient sees what is going on.

Heart is the crucial element of our body and it also requires blood for its continuous functioning. The blood to heart is supplied by the coronary arteries. If these arteries get hardened and narrowed then they impede the blood flow. Generally with ageing in old people this often develops and then there is this angioplasty procedure adopted. When the blood flow to heart is decreased it generally results in angina chest pain and whenever we work more the load comes on heart and it might lead to condition of heart attack.

There are some medicines which are also given in this condition to treat the patient but many times these medicines are of not much use and then the doctors decide for angioplasty. If by doing angioplasty itself the coronary arteries appear to be cleaned then in some cases the doctors will review the stent placement requirement and may not go for it. It varies from case to case. In majority of the cases stent is placed.

The procedure is generally over in 1-2 hours and the patient is released from the hospital the next day and by a weeks time one becomes normal.

Percutaneous Coronary Intervention referred to PCI in abbreviated form is a kind of non surgical procedure where a catheter is placed to open up the blood vessels in the heart. This catheter is known as stent. This will take care of smooth movement of the blood which could otherwise have been difficult for smooth flow as a result of formation of plaque built up.
Myocardial Infraction also known as heart attack occurs due to insufficient supply of oxygen within the valves of the heart and is termed as medical emergency calling for the management of Myocardial Infraction. This is assessed by the heart surgeon when the chest pain has developed in the severe stage due to less supply of oxygen and at this stage it has to be confirmed by the heart specialist whether the symptoms are matching with heart attack or not. Oxygen level of the patient is determined and occurrence of oxygen level below 94 percent with the irregularity of ECG would be the indicative of heart attack.
The doctor will diagnose the patient and accordingly they will take up the next step. Some medications are there to dilute the blood so that there could be smooth supply of blood within the heart region but the same medication may not be effective. Generally with the progression of age, arteries harden impeding the blood flow. With the insertion of stent, blood flow can be regulated giving relief from the chest pain due to smooth supply of blood.
Role of PCI-
PCI deals with a group of invasive procedure aiming at improved blood flow to the myocardium as a result of strengthening of the diseased coronary arteries.PCI technique coupled with the appropriate medications have been studied extensively in the clinical situations. Several studies have shown that PCI is the most preferable to intravenous thrombosis in course of treatment of AMI ( Acute Myocardial Infraction). PCI would prove to be an ideal choice for the patients if performed by the experienced specialist. The specialist should have at least performed 75 angioplasty of varied types in a year.

PCI is an alternative approach to CABG, popularly known as bypass surgery. It is used in patients with acute coronary syndromes and people with unstable angina( to deal with future contingencies). The main cause of heart attacks is blockage of blood vessels becoming an obstacle in the smooth flow of blood, causing all discomforts. So to reestablish the smooth flow of blood this technique is used.
But there are certain factors in which it may prove ineffective, in the case of diabetic patients and severe cases.
The process involved in PCI can be understood as follows:
1)First percutaneous access is gained into the artery by puncturing the artery in the leg or the arm. After that, a sheath introducer is used to cover the wires into the artery.

2) After that a guiding catheter placed at the mouth of the coronary artery is inserted. Through X-ray visualisation cardiologist analyses the size of the coronary artery and then picks the size of the catheter and guidewire as appropriate.

3)Then coronary guidewire is inserted through the catheter into the coronary artery and the cardiologist guides the wire to the site of the blockage. Guidewire acts as a place to stenosis. The deflated balloon is taken to the site of the blockage and after reaching the site it is inflated and stents are implanted to provide support.

Percutaneous coronary intervention is used to open blocked arteries of the heart. In case of a heart attack, angioplasty should be done on the patient. Due to the attack, the heart muscle cells are irreversibly damaged. This type of angioplasty is known as primary angioplasty. Angioplasty surgery helps to correct the symptoms of blocked arteries. Commonly, heart-related diseases include shortness of breath and chest pain for the patient. Percutaneous coronary intervention is useful for quickly opening a blocked artery in case of a heart attack. It helps in reducing damage to the heart and is also helpful in clearing plaque from the coronary arteries. Angioplasty surgery is beneficial because the artery can be brought back to its normal size without the need for major surgery.
The main types of angioplasty are:
Balloon Angioplasty
Laser Angioplasty
Atherectomy
Balloon Angioplasty- In this, the catheter tube is inserted into the blocked artery by making a small incision in the arm or thigh and the catheter is easily inserted through the blood vessels into the artery. Upon entering the narrowed artery, the balloon attached to the catheter tip is inflated; this inflated balloon compresses and flattens the plaque, causing the artery to widen.
Laser Angioplasty- Laser angioplasty also uses a catheter, but a laser is used instead of a balloon. The laser is then passed through the plaque and the blockage is vaporized.
Atherectomy- It is used when even harder plaque cannot be removed with balloon and laser angioplasty. The plaque is completely cut off with the help of a surgical blade. Helps to remove the blade from the affected artery walls.
It is very important to maintain heart health after angioplasty. After this surgery:
Do not consume smoking.
Maintain cholesterol level.
Maintain a healthy weight.
Do regular exercise.