By: Abdi Waluyo Hospital

Overview

What is Percutaneous Coronary Intervention (PCI)?

Percutaneous Coronary Intervention (PCI), also known as Percutaneous Transluminal Coronary Angioplasty & Stenting (PTCA) , is a minimally invasive procedure used to open narrowed or blocked coronary arteries and restore blood flow to the heart muscle.

During the procedure, a cardiologist inserts a thin, flexible catheter through an artery in the wrist (radial artery) or groin (femoral artery) and guides it to the affected coronary artery. A small balloon is inflated to widen the narrowed artery (angioplasty), and in most cases, a coronary stent—a small expandable wire mesh tube—is implanted to keep the artery open and reduce the risk of future narrowing.

PTCA is one of the most effective treatments for coronary artery disease (CAD) and is commonly performed to relieve chest pain (angina), improve blood flow to the heart, and restore circulation during an acute heart attack.

At RS Abdi Waluyo, PTCA is performed by experienced interventional cardiologists using advanced imaging technology in a state-of-the-art Hybrid Catheterization Laboratory (Hybrid Cath Lab). When clinically indicated, the procedure is further optimized using advanced technologies such as Intravascular Ultrasound (IVUS), Optical Coherence Tomography (OCT), Fractional Flow Reserve (FFR), and Intravascular Lithotripsy (IVL) to achieve the best possible outcomes.

Why is PCI Performed?

Your cardiologist may recommend PCI to:

Treat narrowed or blocked coronary arteries caused by coronary artery disease.
Relieve chest pain (angina) that does not improve with medication.
Restore blood flow during an acute heart attack (STEMI or NSTEMI).
Improve blood supply to the heart muscle.
Reduce symptoms such as shortness of breath and fatigue during physical activity.
Improve heart function in selected patients.
Reduce the risk of future cardiovascular complications.
Improve overall quality of life.

The decision to perform PCI is based on your symptoms, coronary angiography findings, heart function, and overall medical condition.

Details of the Procedure

PCI is performed in the Cardiac Catheterization Laboratory under local anesthesia with mild sedation when appropriate.

Before the procedure:

Your cardiologist will review your medical history and current medications.
Blood tests, an electrocardiogram (ECG), echocardiography, and coronary angiography may be performed.
You may be instructed to fast for several hours before the procedure.
Inform your doctor if you have allergies to contrast dye, iodine, or medications.
Certain medications, particularly blood thinners, may require temporary adjustment before the procedure.

The procedure usually takes 30 minutes to 2 hours, depending on the number and complexity of the coronary blockages.

What Happens During the Procedure?

During the procedure:

Local anesthesia is administered to the wrist or groin.
A catheter is inserted into the artery and guided to the coronary arteries using real-time X-ray imaging.
Contrast dye is injected to identify the location and severity of the blockage.
A guidewire is advanced across the narrowed artery.
A balloon catheter is inflated to widen the narrowed segment.
When indicated, IVUS, OCT, or FFR may be used to evaluate the artery and guide treatment.
In heavily calcified arteries, Intravascular Lithotripsy (IVL) may be performed to prepare the vessel before stent implantation.
A coronary stent is implanted to keep the artery open.
Final imaging confirms optimal stent expansion and restoration of blood flow.
The catheter is removed, and the access site is closed using manual compression or a vascular closure device.

Throughout the procedure, your heart rhythm, blood pressure, oxygen level, and overall condition are continuously monitored.

The Role of the Hybrid Cath Lab

The Hybrid Cath Lab combines a fully equipped cardiac catheterization laboratory with the capabilities of a modern operating room, providing significant advantages for both routine and complex coronary interventions.

Benefits include:

High-resolution real-time imaging for greater procedural accuracy.
Image-guided coronary intervention using IVUS, OCT, and FFR to optimize stent selection and placement.
Support for advanced procedures, including IVL for heavily calcified coronary arteries.
Immediate availability of cardiac surgery should emergency surgical intervention become necessary.
Hybrid procedures, combining catheter-based interventions and surgery in selected patients.
Enhanced patient safety, eliminating the need to transfer patients between procedure rooms.
A multidisciplinary Heart Team approach, bringing together interventional cardiologists, cardiac surgeons, cardiac imaging specialists, and anesthesiologists to deliver individualized care.

This integrated environment allows patients with complex coronary artery disease to receive comprehensive treatment in a single, highly specialized facility.

What Should I Expect After the Procedure?

After PCI:

You will be monitored in the recovery area for several hours.
Most patients can return home on the same day or the following day, depending on their condition.
Mild bruising or discomfort at the catheter insertion site is common.
Your doctor will prescribe medications, including dual antiplatelet therapy, to help prevent blood clots within the stent.
You will receive instructions regarding medications, activity, wound care, and follow-up appointments.

Most patients can gradually return to normal daily activities within several days.

What Are the Risks?

PCI is a well-established procedure with a high success rate. However, potential risks include:

Bleeding or bruising at the catheter insertion site.
Blood vessel injury.
Allergic reaction to contrast dye.
Kidney injury related to contrast dye, particularly in patients with pre-existing kidney disease.
Coronary artery dissection or perforation (rare).
Blood clot formation within the stent (stent thrombosis).
Re-narrowing of the artery (restenosis).
Heart attack, stroke, or abnormal heart rhythms (rare).
Emergency coronary artery bypass surgery (very uncommon).

Your healthcare team carefully monitors you throughout the procedure to minimize these risks.

Results and Follow-Up

Following PCI, your cardiologist will evaluate:

Restoration of blood flow through the treated artery.
Improvement in symptoms.
Heart function.
Stent expansion and positioning, when intravascular imaging is used.
Need for additional treatment or lifestyle modification.

Long-term follow-up may include:

Regular cardiology consultations.
Medication review and adjustment.
Blood pressure, cholesterol, and diabetes management.
Smoking cessation support.
Heart-healthy nutrition and exercise counseling.
Cardiac rehabilitation when appropriate.

When Will I Know the Results?

Your cardiologist can usually explain the results immediately after the procedure.

You will receive information regarding:

The severity of the coronary artery disease.
The arteries treated.
The number and type of stents implanted.
The success of the procedure.
Recommendations for recovery, medications, and long-term prevention.

If Additional Blockages Are Found, What Are the Next Steps?

If additional or more complex coronary artery disease is identified, your cardiologist may recommend:

Additional PCI procedures.
Coronary Artery Bypass Graft (CABG) surgery.
Medical therapy.
Lifestyle modification to reduce cardiovascular risk.
Cardiac rehabilitation.
Regular follow-up with your cardiologist.

Treatment recommendations will be individualized according to your coronary anatomy, symptoms, and overall health.

When Should I Call My Doctor?

Contact your doctor immediately if you experience:

Chest pain that returns or worsens.
Shortness of breath.
Persistent bleeding or swelling at the catheter insertion site.
Severe pain, numbness, or discoloration of the arm or leg used during the procedure.
Rapid or irregular heartbeat.
Any new or worsening symptoms.

Seek emergency medical attention immediately if you experience severe chest pain, difficulty breathing, fainting, or symptoms suggestive of a heart attack or stroke.

Why Choose RS Abdi Waluyo for PCI?

At RS Abdi Waluyo, PCI is performed using the latest interventional cardiology technology by a team of highly experienced specialists dedicated to providing safe, precise, and personalized cardiac care.

Our PCI program offers:

Experienced interventional cardiologists specializing in the treatment of coronary artery disease, including high-risk and complex PCI.
Comprehensive intravascular imaging, including IVUS (Intravascular Ultrasound) and OCT (Optical Coherence Tomography), to optimize stent selection and placement.
Physiological assessment with Fractional Flow Reserve (FFR) to determine whether coronary narrowing requires intervention.
Advanced calcium modification using Intravascular Lithotripsy (IVL) for patients with heavily calcified coronary arteries.
24-hour emergency Primary PCI service for patients experiencing acute heart attacks.
A multidisciplinary Heart Team approach, involving interventional cardiologists, cardiac surgeons, cardiac imaging specialists, and anesthesiologists to provide individualized treatment for complex cases.
Comprehensive cardiac care, from diagnosis and intervention to cardiac rehabilitation and long-term follow-up.
Patient-centered care, focused on improving procedural safety, minimizing recovery time, and achieving the best possible long-term cardiovascular outcomes.

By combining advanced technology, expert clinical care, and comprehensive Heart Center services, RS Abdi Waluyo delivers world-class coronary intervention for patients with coronary artery disease, helping restore healthy blood flow, relieve symptoms, and improve quality of life.