Coronary Angioplasty & PCI

Coronary Angioplasty & PCI

Why would I be offered this procedure?

The aim of this procedure is first to diagnose the cause of symptoms (a coronary angiogram) and then, if it is a coronary narrowing, to treat it (with percutaneous coronary intervention, PCI). In patients less likely to have coronary disease we will often recommend a CT scan first (a CT coronary angiogram). If this is negative (i.e. there is no narrowing identified in a coronary artery), then we have avoided an invasive procedure. If it is positive (i.e. there is a narrowing that requires treatment), then we can go ahead and arrange angiography and PCI if needed.

What is coronary angiography?

Coronary angiography is the gold standard test used to determine whether there are any narrowings in the coronary arteries. It involves inserting a long thin tube, called a catheter, through an artery in either your wrist (radial artery) or at the top of your leg (femoral artery). We use local anaesthetic to make the area go numb and may also give you sedation to make you feel relaxed and sleepy during the procedure. The catheter is guided using x-ray until its tip reaches your heart. A dye is then injected through the catheter into each of your heart arteries; this shows the position, size and shape of any narrowings or blockages. If no narrowings or blockages are found, the procedure will finish at this point, although we may need to carry out other tests to find the cause of your symptoms.

What is coronary angioplasty or PCI?

If a narrowing or blockage is found then we will carry out a procedure called an angioplasty or percutaneous coronary intervention (PCI). A very fine wire is advanced through the narrowed part of the coronary artery. Once this is in position, a small balloon is passed over this wire into the narrowed area. Inflating the balloon clears the blockage and a stent (a tubular metal mesh) can then be inserted to keep the artery open. In some cases, additional techniques (such as making pressure measurements, or taking different types of pictures of the arteries) are used to guide the procedure.

What are the benefits and risks?

Both angiography and PCI are safe procedures but there are some risks to consider and it is important that you understand them. We will discuss these with you in clinic and we will also provide you with printed information about the procedure to help you understand the procedure and make an informed choice.

What experience does Dr Dawkins have in PCI?

Dr Dawkins is an interventional cardiologist at the John Radcliffe Hospital in Oxford. He is one of the Consultant Cardiologists responsible for the Heart Attack Service, and he provides emergency angioplasty for patients having heart attacks. In Oxford we treat around 300 patients with the most serious type of heart attack (an ST elevation myocardial infarction) each year, and our times to treatment (known as the door to balloon time, which is the time between the patient arriving in hospital, and the blocked artery being opened by a balloon) are the amongst the very best in the country (the median time in Oxford is 22 minutes).

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    Dr Dawkins has private clinics in Oxford at the Nuffield Manor Hospital and in London at London Bridge Hospital. Please get in touch if you would like to make an appointment. We can usually arrange to see you within a few days. For urgent appointments, a same-day visit or telephone consultation can often be arranged. To arrange an appointment, please complete this form or call us on 020 7205 2024 (London) or 01865 598040 (Oxford).