• About Interventional Cardiology

    PCI Fact Sheet

     


     

    Percutaneous Coronary Intervention (PCI)

    Percutaneous coronary intervention, or PCI, is a medical procedure performed by interventional cardiologists that re-opens arteries in the heart that have become narrowed or blocked due to a build-up of fatty deposits, a condition called coronary artery disease – and also referred to as coronary heart disease or ischemic (is-KEY-mic) heart disease. An estimated 14 million Americans have coronary artery disease.

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    How PCI is Used to Treat Coronary Artery Disease

    The coronary arteries carry blood to the heart. When blood flow through the coronary arteries is slowed or blocked due to the build-up of fats, cholesterol or plaque, the heart muscle is “starved” of the oxygen and nutrients it needs. Patients with reduced blood flow to the heart may experience shortness of breath, chest pain and other symptoms – or they may experience no unusual symptoms. Coronary artery disease, however, increases risk of chest pain (angina), heart attack and sudden death – and is the leading cause of death in the U.S., killing some  652,091 Americans each year. 

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    How PCI is Performed

    PCI is a minimally invasive procedure in which a physician inserts a catheter – a long, thin tube – into an artery in the upper thigh and guides it through the arteries to the heart – and to the area of blockage. With the catheter in place, the doctor then threads a tiny wire carrying a deflated balloon on its tip through the catheter to the narrowed portion of the artery. As the tiny balloon is inflated, it compresses the blockage against the inside wall of the artery. This re-opens the artery so blood may again flow. To “prop” the artery open, doctors also may insert an expandable mesh stent – a tiny “scaffold” made of medical-grade stainless steel – at the site of the blockage. Some stents, called drug-eluting or coated stents, release medication over time to help keep new tissues from growing and re-blocking the artery.    

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    Number of PCI Interventions Performed in the U.S. Each Year

    An estimated 658,000 U.S. patients receive inpatient PCI therapy each year. From 1987 to 2004, the number of procedures increased 326 percent  but Medicare data indicates that the number of procedures has leveled off between 2004 and 2006.

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    PCI’s Place in the Continuum of Care for Coronary Artery Disease

    Medications may be prescribed for coronary artery disease. But when more aggressive treatment is needed, PCI is the most commonly used therapy. Another option is coronary artery bypass surgery, in which a surgeon takes a vessel from the leg or another part of the body to create a graft to allow blood to flow around the blocked coronary artery. Because PCI has been found to produce positive patient outcomes less invasively than bypass surgery, the more invasive procedure is reserved for more complex cases.    

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    New Treatments Using PCI Therapies

    The non-invasive techniques used to treat coronary arteries are being used increasingly to treat other diseased arteries, such as the carotid arteries that supply blood to the brain, the renal arteries that supply blood to the kidneys and the network of vessels throughout the legs and feet. PCI is also being used in treating other heart ailments, such as valve problems or repairing tiny holes between the hearts chambers. Work is underway to use PCI techniques to prevent heart attacks by treating inflamed plaque in the coronary arteries.

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