Revascularization Explained

Percutaneous Coronary Intervention

Angina -- defined as chest pain or discomfort -- is a common ailment and symptom of coronary heart disease. This tightening in the chest is caused by poor blood circulation through the heart's major blood vessels and usually occurs after strenuous activity or a bout of stress. This pain comes in two forms: stable angina and unstable angina. Unstable angina is often a sudden, intense pain that is not lessened by rest. It's life-threatening and needs to be treated immediately. Stable angina, however, is usually a manageable condition and is often predictable. For example, a patient with stable angina knows he will likely experience a tightening in the chest after running up and down a flight of stairs, and the pain will subside if he rests for a few moments. Stable angina usually improves with medication, and if a patient makes significant positive changes in his diet and exercise regimen, his chest pain is often reduced considerably. In extreme cases, stable angina can be treated with procedures such as coronary artery bypass surgery or a percutaneous coronary intervention (PCI), formally known as a coronary angioplasty.

The coronary arteries are responsible for carrying oxygen and nutrient-rich blood to the heart. When they become blocked by built-up plaque -- which consists of fat and cholesterol deposits -- a person may experience angina-related chest pain, a heart attack or other heart-related problems. A PCI is a revascularization procedure that allows doctors to open blockages within arteries by using a balloon catheter -- usually with the placement of a stent -- to restore blood flow to the heart.

This may sound complicated, but it's actually pretty simple. A balloon catheter is a tool that can be inserted into a narrow or collapsing artery. Liquid then expands the balloon, which pushes plaque aside and restores the artery to its normal size. If a stent -- a small mesh tube made of fabric or metal -- is needed, a doctor will place it inside an artery to help keep the area open after a PCI has taken place. The stent is usually coated with medication that prevents an artery from constricting or closing again after the surgery has been completed. A PCI is not as traumatic as some of the more complicated revascularization procedures, and patients are typically able to walk within six hours of waking up from anesthesia.

However, not every attempt at a PCI is successful. Read the next page to find out about what kind of revascularization surgery is an option if a bypass or PCI fails.