Percutaneous Coronary Intervention for Coronary Artery Disease

At NYU Langone, doctors at our cardiac catheterization laboratory locations are experts at performing percutaneous coronary intervention (PCI)—a nonsurgical treatment that uses a balloon and stent to open blocked or narrowed coronary arteries and improve blood flow to the heart. Unlike surgery, a PCI does not require a large incision or general anesthesia, so the recovery time is shorter.

During the procedure, the doctor makes a tiny incision in the wrist or groin, then inserts a thin, hollow tube called a catheter into an artery. The doctor injects a dye that, with the help of X-ray imaging, shows whether the blood vessels supplying the heart muscle have any blockages. If there is a blockage that is best treated with PCI, the doctor discusses that with you before proceeding.

In a PCI procedure, the doctor threads a thin wire across the blockage and then advances a small, uninflated balloon to the treatment site. Once the balloon is in place, it is inflated. As the balloon expands it pushes away the plaque, restoring blood flow through the vessel. The balloon is then removed, and a stent is threaded over the wire and placed across the blockage. A stent is a sophisticated mesh tube that props the blood vessel open and is coated with medication that prevents the blockage from forming again. More than one stent may be necessary, depending on the number, severity, and length of the blockages. Sometimes PCI is used as an emergency procedure during a heart attack to quickly restore blood flow to the heart.

Some blockages are so complex that specialized, highly technical procedures may be needed before placing a stent. These include atherectomy, which uses a small tool to cut through blockages; excimer laser coronary angioplasty, which uses laser mechanisms to break up plaque; and intravascular lithotripsy, which uses shock waves to treat the most-resistant blockages. Interventional cardiologists at NYU Langone, part of NYU Langone Heart, are experts at performing these and other complex procedures.

Once the stent is placed and the doctor is satisfied with the results, the catheter is removed and the small incision is closed. Patients are often discharged the same day as the procedure.

Stents may take some time to heal. During that time, there is a small risk of blood clots forming inside the stents. To prevent this, your doctor prescribes mild blood thinners. Please take any medicine as prescribed and continue taking it until your cardiologist determines it is no longer needed.