Percutaneous coronary intervention (PCI) is an umbrella term for procedures designed to treat coronary artery disease. These procedures include balloon angioplasty and, more recently, coronary stenting. When obstructions within the coronary arteries (blood vessels feeding the heart muscle) become severe, the heart muscle sometimes does not get enough oxygen and nutrients. (This often happens during exercise.) This obstruction causes the heart pain known as angina pectoris.

PCI procedures are performed through a small skin incision, usually in the groin area—hence the name percutaneous (“through the skin”). (Watch video of a stent procedure Before Stent, After Stent.) It requires a local anesthetic similar to what a dentist uses to work on someone’s teeth, and patients usually receive mild sedation. PCI can take from one to several hours to perform and usually requires an overnight stay in the hospital. Patients are usually able to return to work within several days, with minimal restrictions for a few additional days.

PCI is designed to improve blood flow by opening the vessel to normal or near normal. Originally this was done using specially designed small balloons which were inflated within the blockage, stretching the area to improve blood flow. This was successful in the vast majority of patients but had some serious risks, including an abrupt closure of the vessel (requiring emergency heart surgery) and a more insidious narrowing over several months (called restenosis) as the vessel “healed” from the balloon treatment. Coronary stents—metallic spring-like implants—were developed over 10 years ago and have greatly reduced the problem of abrupt closure and the need for emergency surgery (now required less than 1 percent of the time). More recently, stents coated with drugs (drug-eluting stents) modify the healing process and reduce the incidence of restenosis.

Typically, PCI is performed using stents in 80 to 90 percent of patients. Rarely, a balloon alone is used. Frequently this procedure can be performed instead of traditional bypass surgery, but in some patients surgery is preferred. Which approach is best should be determined after discussions with your physicians.

Following successful stenting, patients must take medications designed to keep the stent site open until vessel healing occurs. The cornerstone of this therapy is drugs designed to inhibit blood clotting. Aspirin is given to all stent patients, and a second drug, clopidogril, is required for several months after the procedure.



It is important to remember that PCI does not cure the underlying disease. Continued medical treatment of coronary disease is required.

PCI is especially appropriate for those with continued heart-disease symptoms, despite good medical therapy, or those unable to take adequate medications because of side effects. If readily available, it is the treatment of choice for people having heart attacks.

PCI is very effective in relieving the symptoms of angina.

General risks of the stenting procedure include heart attack (1 to 2 percent), emergency heart surgery (0.5 percent), and, months later, re-narrowing of the treated vessel (<10 percent). The likelihood of complications is somewhat person-specific and should be discussed with your cardiologist.

PCI in the majority of patients is designed to relieve angina, which can be debilitating in many people. In a certain but smaller group of people the treatment can reduce the chance of heart attack and death. For other treatments, please see coronary artery disease.

Urgency varies according to the symptoms: from an emergency in people having a heart attack to elective in those with stable symptoms.