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A percutaneous coronary intervention, or coronary angioplasty with stenting, is a non-surgical procedure used to improve the blood flow to the heart. [1] Coronary angioplasty is indicated for coronary artery diseases such as unstable angina, NSTEMI, STEMI and spontaneous coronary artery perforation. [1]
In 1977, Andreas Gruentzig performed the first successful percutaneous coronary angioplasty. In this procedure, a catheter attached to a small balloon is inserted into the afflicted artery. The balloon is subsequently expanded, compressing the accumulated plaque to allow increased blood flow.
Balloon angioplasty is the inflation of a balloon (often part of an integrated medical device combining a balloon, guidewire, and stent) within the coronary artery to 'crush' the plaque causing the occlusion into the walls of the artery. Balloon angioplasty is still often performed as a part of PCI procedure, it is rarely the only activity ...
Stent technology improved rapidly, and in 1989 the Palmaz-Schatz balloon-expandable intracoronary stent was developed. [24] [25] Initial results with the Palmaz-Schatz stents were excellent when compared to balloon angioplasty, with a significantly lower incidence of abrupt closure and peri-procedure heart attack. [26]
A PCI involves performing a coronary angiogram to determine the location of the infarcting vessel, followed by balloon angioplasty (and frequently deployment of an intracoronary stent) of the stenosed arterial segment. In some settings, an extraction catheter may be used to attempt to aspirate (remove) the thrombus prior to balloon angioplasty.
For coronary artery disease (ischemic heart disease), coronary artery bypass surgery and percutaneous coronary intervention (coronary balloon angioplasty) are the two primary means of revascularization. [2] When those cannot be done, transmyocardial revascularization or percutaneous myocardial revascularization, done with a laser, may be an option.
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