PCI stands for Percutaneous Coronary Interventions, simple put it is locating a blockage in an artery and correcting it with placing a stent. This stent will open the artery back to its original size and continue the normal flow of blood to the heart. This procedure can involve multiple steps and different components to opening an artery. For the sake of this page I will be explain the most basic and simple steps of the procedure. This can be performed in both normal testing as well as emergencies and needs to be completed fast as the muscles of the heart will start to die with a lack of blood flow leading to death. Heart Attacks are some of the most serious situation you will face in the Cath Lab and can occur at any time of the day. Some patients can have complete blockages and seem perfectly fine while others enter the lab with nurses performing CPR, shocking, and using vasopressor’s in an attempt to keep the patient alive until normal blood flow can be restored.

Supplies

• Cath Pack Tray
• Indeflator
• Touhy – Guardian
• Intervention Wire – Runthrough
• Guide Catheter – EBU 3.5
• 50/50 mixture of Contrast and Heparinized Saline
• Balloon – Takeru
• Stent – Onyx Fronteir

Procedural Steps

1. The starting steps will be the exact say as the Left Heart Procedure but will change after taking a CIN recording and seeing a sever blockage that needed intervention.
2. Remove the JL 3.5 Catheter over the exchange wire.
3. Connect the EBU 3.5 guide catheter to the Guardian and insert into the sheath over the Exchange Wire.
4. Connect the Guardian to the ACIST Machine and locate the artery blockage again. When ready use CIN to record the injection to confirm the blockage.
5. Insert the Runthrough into the Guardian and pass the wire as far as you safely can through the blockage.
6. Prep the Indeflator by filling with the 50/50 mixture of Contrast and Heparinized Saline.
7. Insert a balloon of the correct dimension over the Runthrough Wire until it reaches the lesion.
8. Connect the Indeflator to the back of the ballon and slowly increase the atmospheres until the full expansion. Ensure you have reach full expansion but recording a CIN image.
9. Deflate the balloon and remove the balloon over the Runthrough Wire.
10. Prepare the Stent you will be using by dipping the end of it in Saline for easier passage.
11. Insert the Stent over the Runthrough Wire until you reach the lesion.
12. Confirm the location of the stent by recording a CIN image. Ensure the stent has at-least 2mm extra on either end in health artery for proper anchoring points.
13. Increase the atmospheres of the stent until full expansion. Confirm expansion by recording a CIN image.
14. Take final image to show stent has been placed and artery’s normal flow has been restored.
15. End the procedure using the same steps used in the Left Heart Procedure after recording and image with the JL 3.5 Catheter.