Coronary Angioplasty and Stenting (PCI)

Coronary angioplasty, also called percutaneous coronary intervention (PCI), opens a narrowed or blocked heart artery from the inside using a small balloon and, in most cases, a stent. It is carried out through a small puncture in the wrist or groin, without open-heart surgery.

Treats significant narrowings in the coronary arteries
Usually through the wrist or groin under local anaesthetic
A stent (a small mesh tube) usually keeps the artery open
Blood-thinning medicines are needed afterwards
Relieves angina and is life-saving in some heart attacks

What is angioplasty?

A thin catheter is guided to the narrowed artery and a very fine guide wire is passed across the narrowing. A small balloon is inflated to widen the artery, and a stent is then expanded to support the artery wall. Most stents used today are drug-eluting stents, which slowly release a medicine that reduces the chance of the artery narrowing again.

Medicines, stent or bypass: how decisions are made

For many people with stable angina, medicines and lifestyle changes are the foundation of treatment and help reduce the risk of future events. Angioplasty can relieve angina that continues despite medicines. For some patterns of disease, for example narrowings in several arteries or in the left main artery, particularly in people with diabetes, bypass surgery may be the better option. In a heart attack, angioplasty is often urgent.

The right choice depends on your symptoms, the pattern of narrowing in your arteries, how well your heart pumps, your other medical conditions and your preferences. Complex decisions are often discussed by a heart team that includes cardiologists and cardiac surgeons.

Best treatment for angina? Medicine or stent or bypass

Video · 14:23 · Watch on YouTube

What to expect

The preparation is similar to coronary angiography. You will usually be given blood-thinning medicines before the procedure. You are awake, the access site is numbed, and you may feel some chest discomfort while the balloon is inflated. Afterwards you are monitored, and the timing of discharge depends on your condition and the procedure performed.

Recovery and medicines after a stent

Take your antiplatelet (blood-thinning) medicines exactly as prescribed. Do not stop them without speaking to your cardiologist, because stopping too early can cause the stent to block suddenly.
Tell your dentist and any other doctor that you have a stent before any procedure.
Follow the advice you are given about the puncture site, activity and returning to work.
Control your blood pressure, cholesterol and blood sugar, and stop smoking.
Join a cardiac rehabilitation programme if one is available to you.

Long-term follow-up

A stent treats a specific narrowing but does not cure the underlying disease. Regular follow-up, medicines and risk-factor control protect all of your heart arteries in the long term.

Questions patients ask

Is angioplasty an operation?

It is a minimally invasive procedure, not open-heart surgery. It is done through an artery in the wrist or groin, usually under local anaesthetic.

Will a stent cure my heart disease?

A stent treats a specific narrowing; it does not cure atherosclerosis, the process that causes plaque. Medicines and risk-factor control remain essential.

How long will I need blood thinners?

It depends on why the stent was placed and on your bleeding risk. Your cardiologist will advise you. Do not stop or change these medicines on your own.

Can a stent be placed during my angiogram?

Sometimes. If angiography shows a narrowing that needs treatment, and this has been discussed and agreed with you beforehand, angioplasty may be done in the same procedure.

References

Vrints C, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024;45:3415–3537. doi.org/10.1093/eurheartj/ehae177 (opens in a new tab)
Lawton JS, et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization. Circulation 2022;145:e18–e114. doi.org/10.1161/CIR.0000000000001038 (opens in a new tab)
Neumann FJ, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2019;40:87–165. doi.org/10.1093/eurheartj/ehy394 (opens in a new tab)

This page is general information about the condition or procedure, not personal medical advice. Whether a test or treatment is right for you is decided at your consultation. Medical disclaimer.

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