What is an angioplasty (PCI) procedure?

Percutaneous Coronary Intervention (PCI) is a specialized procedure to open up a coronary artery which is narrowed due to plaque build-up. A fine tube, or catheter, is threaded from the artery in the groin, up to the site of the blockage in the heart. The balloon-tip of the catheter is inflated to press the plaque back against the wall of the artery. When the catheter is removed, the artery remains open wider than before, allowing more blood and oxygen to get to the heart muscle.

In some cases, a tiny wire coil, or stent, is inserted with the catheter to help stabilize the newly opened area of plaque. Stents are not necessary for all patients and the Cardiologist makes the decision during the procedure.

Additional information can be found in our Cardiac Catheterization & Angioplasty Patient Information Booklet.

Who performs an angioplasty procedure?

Specialized Cardiologists perform PCI procedures. They receive extensive training in both General Cardiology and Invasive Cardiology (performing angiograms and angioplasties). Cardiac surgeons are trained differently, for surgical procedures, and do not perform PCI.

Where does the angioplasty procedure take place?

It is performed in the Cardiac Catheterization Lab, a specialized case room with advanced imaging technology.

How long does an angioplasty procedure usually take?

The average PCI takes approximately one hour to perform, followed by a recovery phase of 12-16 hours. Most patients remain in hospital overnight and go home the following day.

How does an angioplasty procedure treat heart disease?

PCI does not treat heart disease, which is a chronic disease process related to genetics, lifestyle, diet and other factors. However, it effectively treats the symptoms which result from the narrowing of arteries such as extreme fatigue, chest pain and shortness of breath. Patients usually are able to resume their regular activities quickly following their PCI procedure, then follow-up with their physicians to ensure that they control the underlying factors which contributed to their disease process.

What is Direct Angioplasty?

Direct Angioplasty is the gold standard for the treatment of heart attacks. Certain patients are prone to complications related to “clot-buster” drugs, particularly the elderly. In these cases, the patient goes directly from the Emergency Department to the Cardiac Catheterization laboratory. As a result of the second cardiac catheterization laboratory opening, effective October 1, 2011, TBRHSC will offer Direct Angioplasty services 24/7 for appropriate patients. It is expected that this will be the preferred approach for approximately 100 patients per year.

What does Stand-Alone Angioplasty mean?

Stand-Alone angioplasty means that the service is provided in Centres without Cardiac surgery. In these cases, Centres must make arrangement for surgical backup within a short time-frame and reasonable distance. TBRHSC in partnership with the air and land ambulance systems has emergency back up in Duluth, Minnesota.

How many people from Northwestern Ontario receive angioplasty at TBRHSC?

TBRHSC projects approximately 600 cases per year.

When is cardiac surgery recommended over angioplasty?

A number of patients cannot be effectively treated with PCI and require long-term medications or a coronary bypass operation. This could be due to the extensive nature of their disease or the location of a single narrowing in an artery. Also, some patients have other medical conditions which could make surgery a better option.

Does TBRHSC offer cardiac surgery?

TBRHSC does not offer cardiac surgery. Residents of Northwestern Ontario currently travel elsewhere in the Province for surgery. TBRHSC is in the process of developing a proposal to offer a comprehensive cardiovascular service including both cardiac and vascular surgery. Cardiac surgery closer to home would benefit a further 500 patients per year.

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