Coronary Angioplasty & Stenting

The Procedure

A catheter is advanced fluoroscopically to the blocked coronary artery. A drug-eluting stent (DES) — a metal mesh scaffold coated with antiproliferative medication — is deployed to hold the artery open. Radial artery access via the wrist is preferred over femoral access, offering lower bleeding risk and faster recovery.

Intracoronary Imaging & Assessment

• Fractional flow reserve (FFR) — pressure wire measurement determining whether a lesion is causing ischaemia
• Intravascular ultrasound (IVUS) — cross-sectional plaque and vessel imaging guiding stent sizing and deployment
• Optical coherence tomography (OCT) — high-resolution intracoronary imaging for stent optimisation

Complex PCI Techniques

• Rotational atherectomy for heavily calcified plaque
• Intravascular lithotripsy using sonic pressure waves
• Bifurcation PCI for branch point lesions
• Chronic total occlusion (CTO) PCI for complete arterial blockages

Primary PCI for STEMI

Emergency intervention for heart attack with door-to-balloon time targets below 90 minutes. Every minute of delay increases irreversible myocardial damage — primary PCI is the standard of care for ST-elevation myocardial infarction.

After the Procedure

Dual antiplatelet therapy (DAPT) — combining aspirin with a P2Y12 inhibitor — is mandatory after stenting, typically for 6–12 months for stable disease. Regular follow-up and ongoing cardiovascular risk factor management are essential.