[4] PCI is used to open a blocked coronary artery/arteries and to restore arterial blood flow to heart muscle, without requiring open-heart surgery.

A number of initiatives have been active sponsored by a variety of organizations and hospital groups since the late 1990s to reduce this time to treatment.

PCI is performed using minimally invasive catheter-based procedures by an interventional cardiologist, a medical doctor with special training in the treatment of the heart.

This may delay hospital discharge as flow from the artery into the hematoma may continue (pseudoaneurysm) which requires surgical repair.

Infection at the skin puncture site is rare and dissection (tearing) in the interior wall of an arterial blood vessel is uncommon.

A heart attack during or shortly after the procedure occurs in 0.3% of cases; this may require emergency coronary artery bypass surgery.

Elevated enzymes have been associated with later clinical outcomes such as higher risk of death, subsequent MI, and need for repeat revascularization procedures.

[19] Typically having two lumen paths (a cavity within any tubular structure), the larger one for the navigating highly flexible guidewire and the smaller one for inflating and deflating the balloon or balloon/catheter assembly.

[20] The interventional cardiologist uses the entry point created during the percutaneous access step, to introduce the catheter system and guides it to the occluded area of the coronary artery being treated, using fluoroscopy and radiopaque dyes as an imaging tool.

The information obtained from these two sources enables the cardiologist to track the path of the catheter-device as it moves through the arterial vessels.

Data from these two techniques is used to correctly position the stent and to obtain detailed information relating to the coronary arterial anatomy.

[28] After placement of a stent or scaffold, the patient needs to take two antiplatelet medications (aspirin and one of a few other options) for several months to help prevent blood clots.

The aim is to create cracks in the calcium within the vessel wall in order to increase the likelihood of successful expansion of the stenosis and delivery of the final stent.

However, coronary intravascular lithotripsy using acoustic shockwaves is a novel approach for treating superficial and deep calcium in the vessel wall.

Patients are generally advised to 'take it easy' for a week or two and are instructed to be cautious not to lift any substantial weight, this is primarily to ensure the access site heals.

Those patients at high risk of suffering from complications and those with more complexed coronary issues, angiography may be indicated regardless of the findings of non-invasive stress tests.

[36] Cardiac rehabilitation activities are dependent on many factors, but largely are connected to the degree of heart muscle damage prior to the PCI/DES procedure.

The preponderance of studies do suggest that CABG offers advantages in reducing death and myocardial infarction in people with multivessel blockages compared with PCI.

[41] Different modeling studies have come to opposing conclusions on the relative cost-effectiveness of PCI and CABG in people with myocardial ischemia that does not improve with medical treatment.

[48] Complete revascularization of all stenosed coronary arteries after a STEMI is more efficacious in terms of major adverse cardiac events and all-cause mortality, while being safer than culprit-vessel-only approach.

[50] The study compared stenting as used in PCI to medical therapy alone in symptomatic stable coronary artery disease (CAD).

After this trial there were widely publicized reports of individual doctors performing PCI in patients who did not meet any traditional criteria.

[39] The 2017 ORBITA study[56] has also caused much controversy, in that it found that following percutaneous coronary intervention there was no statistically significant difference in exercise time compared with medical therapy.

[57] Others have noted the small sample size with insufficient power to detect outcome differences and the short 6 week duration of the trial.

[59] The 2019 ISCHEMIA trial[60] has confirmed that invasive procedures (PCI or CABG) do not reduce death or heart attacks compared to medical therapy alone for stable angina.