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Percutaneous Coronary Intervention (PCI)

Clinical Subject Page

Percutaneous Coronary Intervention (PCI)

Also called

Coronary Angioplasty

ICD-10

02703ZZ

Specialty

Cardiology

Onset

For Acute & Chronic Conditions

Reviewed

July 2026

On This Page

Overview

Percutaneous coronary intervention (PCI) is a minimally invasive catheter-based procedure used to restore coronary blood flow by balloon angioplasty with or without stent implantation.

Indications

  • Acute STEMI (primary Percutaneous Coronary Intervention PCI)
  • High-risk NSTEMI/Unstable angina
  • Symptomatic chronic coronary syndrome despite optimal medical therapy
  • Significant coronary artery stenosis causing ischemia
  • Cardiogenic shock due to acute MI
  • In-stent restenosis
  • Selected patients with multivessel coronary artery disease

Contraindications

    • Absolute

      • No absolute contraindications in life-saving primary Percutaneous Coronary Intervention (PCI)

      Relative

      • Severe contrast allergy
      • Advanced renal failure
      • Uncontrolled bleeding disorder
      • Inability to receive dual antiplatelet therapy
      • Severe uncontrolled hypertension
      • Active infection (selected cases)

Pre-Procedure Assessment

  1. Clinical Assessment

    • History and physical examination
    • Hemodynamic stability
    • ECG
    • Cardiac biomarkers

    Laboratory

    • CBC
    • Renal function
    • Electrolytes
    • Coagulation profile
    • Blood glucose

    Imaging

    • Coronary angiography
    • Echocardiography (if indicated)

    Preparation

    • Informed consent
    • Aspirin loading
    • P2Y12 inhibitor loading
    • Anticoagulation
    • Assess contrast allergy and kidney function

Percutaneous Coronary Intervention (PCI) Procedure (Step-by-Step)

  • Obtain vascular access (radial preferred; femoral if required)
  • Advance catheter to the coronary arteries
  • Perform coronary angiography
  • Cross the lesion with a guidewire
  • Balloon angioplasty (predilation if needed)
  • Deploy coronary stent
  • Post-dilation (if necessary)
  • Confirm adequate coronary flow (TIMI 3 flow)
  • Remove catheter and achieve hemostasis

Types of Stents & Devices

  • Stents

    • Drug-eluting stent (DES) (preferred)
    • Bare-metal stent (BMS) (rarely used)

    Other Devices

    • Balloon catheter
    • Guidewire
    • Guiding catheter
    • Intravascular ultrasound (IVUS)
    • Optical coherence tomography (OCT)
    • Rotational atherectomy
    • Intravascular lithotripsy (selected calcified lesions)

Post-Percutaneous Coronary Intervention (PCI) Care

    • Continuous ECG monitoring
    • Monitor vascular access site
    • Dual antiplatelet therapy (Aspirin + P2Y12 inhibitor)
    • High-intensity statin
    • Risk-factor modification
    • Cardiac rehabilitation
    • Early ambulation (radial access)
    • Follow-up for recurrent symptoms
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Related Topics

Complications of Percutaneous Coronary Intervention (PCI)

    • Coronary artery dissection
    • Coronary perforation
    • Acute stent thrombosis
    • Restenosis
    • Bleeding or hematoma
    • Contrast-induced nephropathy
    • Stroke
    • Arrhythmias
    • Myocardial infarction
    • Death (rare)

Prognosis of Percutaneous Coronary Intervention (PCI)

  • Excellent procedural success (>95% in experienced centers)
  • Primary Percutaneous Coronary Intervention (PCI) significantly reduces mortality in STEMI.
  • Drug-eluting stents have lower restenosis rates than bare-metal stents.
  • Long-term outcomes depend on adherence to medical therapy and risk-factor control.

Key Points / Clinical Pearls of Percutaneous Coronary Intervention (PCI)

    • Primary Percutaneous Coronary Intervention (PCI) is the treatment of choice for STEMI.
    • Radial artery access is preferred because it reduces bleeding complications.
    • Drug-eluting stents are the standard of care.
    • Dual antiplatelet therapy is essential after stent implantation.
    • TIMI grade 3 flow indicates successful reperfusion.
    • Secondary prevention (statins, BP control, smoking cessation, cardiac rehabilitation) is crucial for long-term success.