PCI (Percutaneous Coronary Intervention: Dilation of a vessel narrowing (stenosis) with Balloon and Stent
If vessel narrowing (stenosis) leads to blood flow disturbances, the vessel will be dilated with a small balloon and kept open by a vascular support structure (stent).
If the diagnostic examination for coronary heart disease gives reason to suspect circulatory disturbances (ischemia) of the heart, the patient should receive a heart catheterization. If the suspicion proves to be founded, which may require additional techniques such as IVUS (intravascular ultrasound) or Pressure Wire (FFR), a coronary intervention (PCI) will be performed within the same sitting.
Hereby the heart catheter that has been used for the coronary angiography is being exchanged for a so-called guiding catheter. The guiding catheter has an inner lumen (hollow space) that allows to transport another smaller catheter inside, this one mounted with a balloon and stent. In this way the balloon catheter is advanced to the coronary arteries.
Then a very thin guide wire is inserted which is used to pass through the actual stenosis inside the vessel. This takes place under x-ray control. Over this guide wire the empty, folded balloon can be moved forward, and then is being dilated with a pressure gauge and filled with constrast medium. To give long-term support to the vessel usually a vessel support structure – a stent – is being implanted simultaneously. This procedure is termed PCI – Percutaneous Coronary Intervention.
Medications after stent treatment
After stent implantation, and depending on the type of stent, patients have to take between 4 weeks or up to one year the following drugs: Aspirin (Ass100) and an additional antiplatelet medication (e.g. Clopidogrel). These thrombocyte aggregation inhibitors prevent the accumulation of platelets (thrombocytes) on the stent and coronary vessels. The coronary intervention can very well be followed up using cardiac ultrasound and cardiac MRI.
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Peter Osypka Herzzentrum
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