Percutaneous interventional cardiac procedures

Abstract

Percutaneous coronary intervention is the term applied to a variety of percutaneous, catheter-based procedures that accomplish revascularization by angioplasty (enlargement of a vessel lumen by modification of plaque structure), stenting (deployment of an internal armature or stent), atherectomy (removal or ablation of plaque), or thrombectomy (removal of thrombus). The most common single indication for percutaneous coronary intervention is acute coronary syndrome. Randomized trials have shown that direct intervention for ST-elevation myocardial infarction is superior to initial thrombolytic therapy when performed in appropriate centres, and it can be used as a salvage procedure after failed thrombolytic therapy. Balloon angioplasty is the traditional, basic technique of coronary intervention, but this is now uncommonly employed as a stand-alone treatment. A variety of percutaneous techniques can be used to remove atheroma or thrombus from coronary arteries as a prelude to angioplasty/stenting.