Percutaneous Coronary Intervention

UT Southwestern Medical Center’s expert cardiologists offer innovative, evidence-based approaches to treat coronary artery disease and other heart diseases.

We participate in research at the national level on the latest advancements in minimally invasive heart procedures. 

Experience in Minimally Invasive Heart Care

Percutaneous coronary intervention (PCI) is a minimally invasive procedure that opens narrowed or blocked coronary (heart) arteries. In a PCI, doctors perform angioplasty (a procedure to repair or open a blood vessel) and place stents (tiny, metal mesh tubes inserted into blood vessels to keep them open).

The Clinical Heart and Vascular Center at UT Southwestern is one of the country’s leading cardiovascular programs, with experts who are at the forefront of the latest research to treat atherosclerosis and coronary artery disease. We offer our patients extensive experience in minimally invasive heart procedures to provide safe, effective care with faster recovery times than traditional surgery allows.

Conditions Treated with Percutaneous Coronary Interventions

When excess cholesterol and other fats build up in the bloodstream, they can collect inside artery walls. This buildup is called plaque, and it causes a condition known as atherosclerosis.

PCI can treat conditions that result from atherosclerosis, such as:

• Chest pain (angina)
  
• Coronary artery disease
  
• Heart attack
  

Treatment

In a PCI, doctors first perform a type of angioplasty involving a cardiac catheterization, which uses a catheter (a thin, flexible tube) to access the heart. The doctor makes a tiny incision, usually in the wrist, to access an artery. The catheter is inserted into the artery and carefully threaded to the heart using live imaging as guidance.

The doctor then inserts a tiny balloon using the catheter and guides it to the blocked area of the artery. Inflating the balloon presses the plaque against the artery walls, opening the vessel to allow blood flow.

At UT Southwestern, our cardiologists perform several angioplasty techniques in addition to the balloon approach, such as:

• Laser angioplasty: Doctors use a laser-tipped catheter, instead of a balloon, to open the artery by sending beams of light to vaporize the blockage.
• Bare-metal stents: In some cases, doctors insert a tiny, metal mesh tube in the artery to keep it open.
• Drug-eluting stent: This type of stent slowly releases medication over time that helps prevent scar tissue from forming and reduces the risk of future blockages.
• Rotational atherectomy: Doctors use a catheter with an abrasive tip to remove plaque from an artery by essentially “sanding” it off artery walls. The abrasive tip grinds plaque into microscopic particles to avoid creating another blockage further downstream.
• Orbital atherectomy: This atherectomy technique uses an abrasive “crown,” a circular section on the catheter that spins around the wire to remove plaque from artery walls. Orbital atherectomy also grinds plaque into microscopic particles.

Percutaneous Coronary Intervention: What to Expect

Pre-Procedure Details

The surgeon provides specific instructions to the patient before the PCI and explains risks such as bleeding, infection, or adverse reaction to anesthesia.

Patients should not eat after midnight the night before the surgery.

On the day of surgery, the patient arrives at the hospital, registers, and changes into a hospital gown. A nurse reviews the patient’s charts to ensure there are no problems.

Patients receive moderate sedation before being taken to the operating room, where the surgeon verifies the patient’s name and procedure before any medication is given. The procedure begins once the sedation is in effect. 

Procedure Details

In a PCI, the cardiologist makes a tiny incision in the groin or wrist to access an artery and inserts the catheter with a tiny, deflated balloon or laser device at its tip. 

If the doctor decides that a heart stent will help keep the spot in the artery open, a stent is placed in the area where the angioplasty was performed. The small, lattice-shaped metal tube acts as a scaffolding to keep the artery open. Depending on each patient’s specific case, the doctor might use a drug-eluting stent with medication to help prevent future blockages.

When the procedure is complete, all catheters and guidewires are removed, and the small incision is closed with stitches. 

Post-Procedure Details

After the procedure, patients are taken to the postoperative recovery area and monitored.  

The length of the hospital stay depends on how quickly the patient is able to recover and perform some physical activity. In many cases, patients can go home the same day.

Support Services

UT Southwestern’s cardiac rehabilitation specialists create customized plans that integrate proper nutrition, exercise, and, if necessary, nicotine cessation into patients’ lifestyles to improve their cardiovascular health.

Clinical Trials

As one of the nation’s top academic medical centers, UT Southwestern offers a number of clinical trials aimed at improving the outcomes of patients with cardiovascular disease. 

Clinical trials often give patients access to leading-edge treatments that are not yet widely available. Eligible patients who choose to participate in one of UT Southwestern’s clinical trials might receive treatments years before they are available to the public.