Percutaneous Coronary Intervention Treatment

What is Percutaneous Coronary Intervention?

Percutaneous Coronary Intervention (PCI, called angioplasty with stent) is a non-surgical operation that uses a thin flexible tube (called as a catheter) for placing a small structure known as a stent for opening up blood vessels in the heart that have been narrowed by the plaque buildup, a condition called as atherosclerosis.

Types of Percutaneous Coronary Intervention:

• Balloon angioplasty: Some catheters are tiny with folded balloons on their tips. Once the doctor reaches a blocked or narrowed artery, the balloon is inflated thus resulting in the opening of the artery. The balloon attached on the tip is then deflated and removed.
• Angioplasty with stent: In addition to balloon treatment, the doctors usually place a stent, a tiny mesh tube that the doctors expand and leave behind for keeping the artery open. Now a day’s most of the stents comes with coatings that slowly release special drugs. The drugs released to decrease the scar tissue buildup, thus reducing the requirement for further treatment. Dissolvable stents are new choices available that does not leave any metal in the body permanently.
• Laser angioplasty: Some catheters come equipped with a laser, allowing the surgeons to vaporize the arterial blockages. Though most of the people will not require any laser angioplasty, it provides an additional treatment alternative.
• Rotational atherectomy: Surgeons can use a special catheter-based tool for drilling out the challenging calcium deposits in the arteries. Atherectomy is not generally used since other angioplasty tools have improved, but it can be invaluable in some of the cases.
• CTO (Chronic Total Occlusions): Some of the vessels have been completely blocked for a long time and these vessels are very difficult to open. Recent advancement in devices and the techniques, the surgeons can fix most of the complex coronary artery blockages.

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Why the Percutaneous Coronary Intervention is performed?

Percutaneous Coronary Intervention improves the blood flow, resulting in the decrement of the heart-related chest pain, making the patients feel better and increasing the patient’s ability to be active. Percutaneous Coronary Intervention is generally scheduled ahead of time.

Before the Surgery

The doctor will explain the benefits and risks of the surgery.

Before the surgery is being operated, the patients must inform the doctor if:

• The patients had any reaction to iodine, contrast dye, or any other serious allergic reaction
• The patients have asthma
• The patients have an allergic reaction to any medication.
• The patients have any bleeding problems or are taking any blood-thinning medicines
• The patients have diabetes or a history of kidney problems
• The patients have body piercings on their abdomen or chest
• The patients have had any recent change in their health.
• The patients are pregnant.

Symptoms leading to PCI Treatment

A brief overview of Angioplasty or Percutaneous Coronary Intervention (PCI) is a procedure deemed to address coronary artery disease (CAD). It is usually advised when the blood vessels supplying the heart muscle (coronary arteries) become narrowed or blocked, usually by cholesterol deposits, and leads to signs that compromise heart function.

Here are common symptoms that may lead to PCI treatment:

• Chest Pain
• Shortness of Breath
• Fatigue
• Dizziness or Light-headedness
• Heart Attack
• Abnormal EKG Results
• Positive Stress Test
• Elevated Cardiac Biomarkers

Risk Factors of PCI Treatment

PCI must be understood to be a procedure that has its risks even though it is widely regarded to be a safe intervention. These risks include and are determined by the health of the person, the degree of their coronary artery disease and even the level of difficulty of the procedure.

Below are some of the key risk factors associated with PCI:

• Age 
• Chronic Kidney Disease
• Diabetes
• Severe Coronary Artery Disease
• High Blood Pressure
• Heart Failure
• Previous Heart Surgery
• Blood Clotting Disorders
• Complications from Stents
• Arrhythmias
• Bleeding 
• Stroke

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Causes leading to PCI Treatment

The main reasons that initiate PCI usually concern the blockage or constriction of the coronary arteries with fresh oxygenated blood for the cardiac muscles.

Here are the common causes that can lead to PCI:

• Atherosclerosis
• Coronary Artery Spasm
• Acute Myocardial Infarction
• Chronic Stable Heart Attack
• Unstable Heart Attack
• Coronary Artery Dissection
• ST-Elevation Myocardial Infarction
• Non-ST- Elevation Myocardial Infarction
• Cardiogenic Shock
• Recurrent Ischemia
• Valvular Heart Disease

Facilities and Services offered for International Patients for Percutaneous Coronary Intervention Surgery

Most of the leading hospitals and medical centres especially those with specialized cardiac centers make it easier for the international patient through providing a number of services that flow with the treatment process.

Here’s an overview of the facilities and services commonly provided:

• Pre-Procedure Consultation
• Medical and Diagnostic Services
• Language Support
• Assistance with Travel Arrangements
• Treatment and Surgery Facilities
• Post-Procedure Care
• Visa Assistance
• Post-Discharge Services

Procedure for the Percutaneous Coronary Intervention

Before the procedure

• Shortly before the surgery, the patients may be given a sedative to help them relax. 
• The hair in the groin site around where the catheter is to be inserted may be clipped as per the requirement. 
• An intravenous (IV) line is inserted so if required, the patients may be given medicines quickly. 
• Electrodes will be placed on the body for monitoring the patient’s heart, and a small device known as a pulse oximeter may be clipped on an ear or a finger for tracking the oxygen level in the patient’s blood.

During the procedure

• Most of the Percutaneous Coronary Intervention is conducted with the patient are given sedates but are not asleep. 
• The patients will have to lie on their back on an operation table for the operation. 
• A local anaesthetic will be injected into the skin at the area where the catheter is to be inserted. 
• Once the local anaesthetic has taken effect, the catheter will be inserted into the blood vessels of the patients. 
• The patients may feel a brief pinch or sting as the needle goes through the skin and some pressure within the artery as the catheter is being moved from the area. 
• If the patients are uncomfortable, they must tell their doctor and if necessary additional pain medicines may be given to the patients. 
• When the catheter reaches the patient’s heart, the contrast dye will be released to the site where the blood vessel is narrowed. 
• When the contrast dye is released in the body, the patient may experience a brief flushing sensation or feeling of warmth. 
• Some patients may also feel a metallic or salty taste in the mouth, or patients may experience a brief headache. 
• A few patients may feel nauseated or even vomit, but this is very rare. 
• These effects are harmless and generally last for only a few minutes or so. 
• When the narrowing is identified, the catheter will be further advanced so that the special tip can be activated. 
• When the procedure is finished, the catheter will be withdrawn and pressure will be put on the insertion area to stop the bleeding from the body. 
• Once the bleeding has stopped from the body, a tight bandage will be applied. 
• The patients will be required to remain to lie flat during the time of operation. 
• If the catheter was inserted in the patient’s groin, the patients will have to keep their leg straight for a few hours. 
• If the catheter was inserted in the patient’s arm, the arm will be kept elevated on pillows and will be kept straight with an arm board.

After the procedure

• The patients will be able to go to a recovery room after several hours of observation. 
• The patients will be asked to remain in their bed for at least 6 hours, depending upon their specific condition. 
• Pain medicines will be given if the patients experience any discomfort. 
• The patients will be encouraged to drink more water and other fluids for helping them to flush the contrast dye from their body. 
• Most of the patients spend the night in hospital after a Percutaneous Coronary Intervention.

Success Rate of Percutaneous Coronary Intervention Surgery

The success rate of performing PCI is 90%-95%, and it is very effective in alleviating and preventing new heart attacks. However, the result can be altered through several factors such as the degree of CAD, the condition of the patient, and the kind of stents to be installed. PCI has a low complication profile, especially in academic centres or principal teaching hospitals, and is beneficial for the majority of candidates in regards to survival and quality of life.

Best Hospitals for Coronary Intervention Treatment

• Max Hospital, Saket
• Fortis Memorial Research Institute, Gurgaon
• Medanta The Medicity, Gurgaon
• Artemis Hospital, Gurgaon

Best Doctors for Coronary Intervention Treatment

• Dr. Arvind Das
• Dr. Krishna S Iyer
• Dr. Naresh Trehan
• Dr. Murtaza A Chishti

Why Choose GetWellGo for PCI?

GetWellGo may be a preferred option for Percutaneous Coronary Intervention (PCI) because of the following factors, and if they meet all the criteria mentioned above, they treat international patients.

Here are some key reasons why someone might choose them:

• Expertise and High Success Rates
• Comprehensive Patient Care
• Advanced PCI Techniques
• Comprehensive Follow-up Care
• Transparent Pricing
• Visa Assistance
• Multilingual Support
• Travel and Accommodation Services

Conclusion

Percutaneous Coronary Intervention abbreviated as PCI is a less invasive procedure designed for CAD by widening arteries that supply blood to the heart. Achieving a success rate of 90%-95%, the treatment bring near immediate symptom alleviation, lower risk of heart attack and better survival probabilities. The first outcome is enhanced quality of life, second is faster convalescence and the third one is lower incidence of bypass surgery. PCI is effective based on conditions such as where and how many blockages are present, the patient’s condition, and other innovations such as drug eluting stents.

FAQ

1. What are the benefits of PCI?

• Improved Blood Flow: Helps to supply blood to the heart muscle in normal manner and constricts the danger of heart attack or more heart damage.
• Symptom Relief: Control symptoms such as chest pain (angina), shortness of breath and fatigue making patient’s lives more comfortable.
• Reduced Need for Surgery: Stands as a less aggressive procedure than CABG in many instances; of especial value for single or two-vessel disease.
• Shorter Recovery Time: In comparison with traditional heart surgery also known as open-heart surgery, the PCI normally results in a shorter rehabilitation period and patients can resume their normal activity soon after the procedure.
• Minimal Hospital Stay: Majority of the PCI procedures are performed using percutaneous techniques or, at best, as emergency procedures, with majority of the patients admitted as outpatients or to the hospital for 24 hours only.

2. How effective is PCI?

• The results of the PCI are encouraging: the success rate in this method is between 90 and 95%. The success factors depend on the location and density of lesions, the number of diseased vessels and the general condition of the patient along with the type of stent. DES are less likely to reoccur by narrowing the artery again (restenosis), and are more effective in the long-term results.

3. How long does it take to recover after the procedure known as PCI?

• Immediate Recovery: Many patients can be discharged a few hours to 24 hours after the PCI, depending on the aggressive nature of the process and the patient’s condition.
• Full Recovery: The complete healing period is approximately one to fourteen days after which the patient should be keen not to overexert themselves.
• Return to Normal Activities: Again, most patients can practice activities such as walking without aid within the first week, but other activities which require more energy, and exercises can begin after between 4-6 weeks depending on the doctor’s advice.
• Post-Procedure Care: Patients after PCI are usually started on medications such as antiplatelet drugs (aspirin, clopidogrel) to avoid formation of clots around the site of the stent and lower risk of complications.
   

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