Interventional Procedures

Coronary Angioplasty (PCI)

Coronary angioplasty, also called percutaneous coronary intervention (PCI), is a procedure used to open narrowed or blocked heart arteries and improve blood flow to the heart muscle.

Why is Angioplasty Done?

Your doctor may recommend angioplasty if you have:

  • Chest pain (angina)
  • Shortness of breath caused by reduced blood flow to the heart
  • A heart attack
  • Significant narrowing seen on heart tests or coronary angiography

The goal is to restore blood flow and reduce symptoms or heart damage.

Before the Procedure

You may be asked to:

  • Avoid eating or drinking for several hours beforehand
  • Tell your doctor about any allergies, especially to iodine or contrast dye
  • Inform staff about medications you take, including blood thinners or diabetes medicines
  • Have blood tests or an ECG before the procedure

During the Procedure

The procedure is performed in a cardiac catheterisation laboratory (“cath lab”). You are usually awake but given medication to help you relax.

  1. Local anaesthetic is injected at the wrist or groin — you will feel a brief sting.
  2. A thin tube (catheter) is inserted into an artery in the wrist or groin and guided to the heart.
  3. A small balloon is inflated to widen the narrowed section of the coronary artery.
  4. Often, a tiny metal mesh tube called a stent is placed to help keep the artery open.

The procedure typically takes 30 minutes to 2 hours.

Benefits

Angioplasty may:

  • Relieve chest pain
  • Improve exercise tolerance
  • Improve blood flow to the heart
  • Reduce heart damage during a heart attack
  • Reduce the risk of future heart attack
  • Improve quality of life

Risks and Complications

Most procedures are successful, but risks can include:

  • Bleeding or bruising at the catheter site
  • Blood clots
  • Re-narrowing of the artery
  • Heart attack
  • Stroke
  • Irregular heart rhythms
  • Kidney problems from contrast dye
  • Allergic reaction to dye
  • Rarely, emergency coronary bypass surgery or death

Recovery

In hospital

  • Many people go home the same day or after one night.
  • The wrist or groin site is monitored for bleeding.
  • You may be asked to drink extra fluids to help clear the contrast dye.

At home

  • Avoid heavy lifting for several days, especially if the groin was used for access.
  • Keep the puncture site clean and dry.
  • Take medications exactly as prescribed.
  • Attend all follow-up appointments.

Seek urgent medical attention if you develop:

  • Chest pain
  • Severe shortness of breath
  • Severe bleeding
  • Fever
  • Increasing swelling or redness at the insertion site
  • Numbness or colour changes in the limb used for access

Medicines After Angioplasty

You will usually need:

  • Aspirin
  • A second antiplatelet medicine (such as clopidogrel, ticagrelor, or prasugrel)
  • A cholesterol-lowering medication (statin)

It is very important not to stop antiplatelet medicines unless instructed by your doctor.

Lifestyle Changes After Angioplasty

Angioplasty treats narrowed arteries but does not cure coronary artery disease. Long-term heart health is improved by:

  • Stopping smoking
  • Eating a heart-healthy diet
  • Regular physical activity
  • Maintaining a healthy weight
  • Managing diabetes, blood pressure, and cholesterol
  • Attending cardiac rehabilitation

Cardiac rehabilitation programs help with recovery, exercise, education, and emotional support.