Percutaneous Coronary Intervention

Percutaneous Coronary Intervention

Some patients are already familiar with this medical procedure (Percutaneous Coronary Intervention) but they know it as Angioplasty or as Coronary Angioplasty. These terms, as well as the abbreviation PCI refer to the same clinical therapeutic technique. This type of intervention is widely employed in the therapy of patients who present narrowed (stenotic) coronary arteries (this medical condition is a common form of coronary heart disorder). This type of medical problem occurs due to the abnormal build-up of cholesterol laden plaques (a consequence of the presence of atherosclerosis). Only a professional interventional cardiologist is allowed to perform this type of medical procedure.

A patient can undergo Percutaneous Coronary Intervention if his or her medical provider considers that this form of therapeutic technique would be effective in eliminating or at least reducing the unpleasant clinical manifestations of the individual’s heart disorder (the presence of such a condition can trigger chest pain / angina, congestive heart failure, dyspnea, and so on). In certain cases, a surgeon may perform a Percutaneous Coronary Intervention in order to abort an acute form of myocardial infarction (studies have shown that this type of therapeutic technique may reduce mortality in certain specific medical cases).

The advantage of this type of Angioplasty is that this medical procedure is less invasive than CABG (another medical intervention called coronary artery bypass surgery) without yielding inferior results in the case of patients who suffer from single-vessel coronary heart disorder. However, patients who have been diagnosed with the presence of multi-vessel CAD (in such cases, the patients present 2 or more affected arteries) should undergo CABG rather than Percutaneous Coronary Intervention, as the former has shown to be more effective and safer than the latter. A recently performed medical study has cast severe doubts on the effectiveness of this type of coronary medical procedure in the case of patients who are suffering from non-acute coronary disorder.

Percutaneous Coronary Intervention Description

This type of medical coronary intervention consists in several steps; it should be performed only by a specialized cardiac invasive medical provider, who has the needed training in this type of clinical procedure. During the first step of the Percutaneous Coronary Intervention, the specialist will have to gain access into the leg’s femoral artery (in fewer cases, the cardiac specialist will choose to insert the “introducer needle” in the brachial artery or in the radial artery – both of which are located in the arm). This part of the intervention is known as the percutaneous access. The artery is kept open and the bleeding is controlled through the placing of a “sheath introducer”; through this device, the surgeon will insert the catheter, a flexible, very long, plastic tube; the tip of the tube will reach the mouth of the patient’s coronary artery. This catheter is also meant to allow the radiopaque agents (most of these medical substances are derivates of iodine) to be injected and reach the coronary artery. In this way, the patient will be able to see the disease state and also the localization of the lesions with the help of x-rays.

Depending on the results of the x-ray visualization, the cardiac specialist will choose a special type of coronary guidewire and balloon catheter that will be employed during the further steps of the Percutaneous Coronary Intervention. The guidewire is inserted through the catheter and it reaches the coronary artery, at the site of the blockage / stenosis .When the guidewire is accurately positioned, it becomes a pathway to the stenosis; now, the surgeon will place the balloon catheter, which will contain the guidewire. When the deflated balloon reaches the arterial blockage, it will be inflated; through this way, the plaque is compressed and the arterial wall is forced to expand. You should feel free to consult with your personal medical specialist if you need further information or explanations about Percutaneous Coronary Intervention description.

Percutaneous Coronary Intervention Related Medication

As we have mentioned in the previous chapter, a patient who is to undergo Percutaneous Coronary Intervention will have to be administered a special radiopaque agent, which will enable the cardiac professional accurately investigate the patient’s arteries and effectively locate the place of the blockage / stenosis. Most of these medical substances are based on iodine. Preventing the formation of unwanted blood clots is crucial for the well being of the patient who is to undergo this type of clinical procedure (Percutaneous Coronary Intervention), especially during the x-ray visualization. For this reason, numerous individuals who undergo this investigation are also administered blood thinners (such as Heparin), which will maintain a proper blood flow.

Two medicines that are very commonly employed during Percutaneous Coronary Interventions are Integrilin and Angiomax. While the former is a glycoprotein platelet inhibitor and has the generic name of eptifibatide, the former is a very effective thrombin inhibitor which is generically called bivalirudin. Both of these medical products, along with Heparin, are employed in order to prevent the formation of blood clots during special cardiac medical procedures. However, the administration of such products is linked to certain medical risks and / or contra-indications. For example, patients who are allergic to the ingredients of Angiomax or who present active severe bleeding must not be administered this medication; the same advice is valid for those who suffer from hemophilia or other severe bleeding medical problem. Certain medical products may interact with the use of Angiomax; in other words, patients who have been recently treated with thrombolytics, platelet inhibitors, glycoprotein IIb / IIIa inhibitors, anticoagulants, and so on must not be administered this product. On the other hand, patients who have a medical history of brain tumors, head injury, aneurysms, stroke, and so on, who suffer form hypertension or other blood disorders must avoid the use of Integrilin. If a patient who has been treated with any type of blood thinning medication experiences uncontrollable bleeding, he or she should immediately seek the adequate medical attention. Such individuals should go to the nearest medical center, where they have access to professional, medical assistance. If you have any questions about the medicines that can be employed during a Percutaneous Coronary Intervention you should seek your PD’s professional help.