A primary angioplasty (also known as percutaneous coronary intervention or PCI is a critical, life-saving procedure for patients experiencing an acute heart attack (specifically, a ST-segment elevation myocardial infarction or STEMI. The underlying cause of a STEMI is typically the complete blockage of a coronary artery due to a ruptured plaque and the formation of a blood clot, which prevents oxygen and nutrients from reaching a section of the heart muscle.
The primary goal of the procedure is rapid reperfusion—the restoration of blood flow to the affected heart muscle—to minimize damage. Time is of the essence, summarized by the phrase “Time is muscle.”
The procedure is usually performed urgently in a cardiac catheterization laboratory. A cardiologist inserts a catheter, often through an artery in the wrist or groin, and threads it up to the blocked coronary artery. A wire is passed across the blockage, and a tiny balloon is inflated to compress the clot and plaque against the artery wall.
Role of the Stent
In most cases, a drug-eluting stent (a small mesh tube) is then deployed at the site of the blockage. The stent acts as a scaffold to keep the artery permanently open and prevent it from narrowing again (restenosis).
By quickly opening the blocked artery, primary angioplasty significantly reduces the size of the heart muscle damage, lowers the risk of severe complications like heart failure and dangerous arrhythmias, and dramatically improves the patient’s long-term survival and quality of life. This direct mechanical restoration of blood flow is considered the gold standard treatment when it can be performed quickly, ideally within 90 minutes of a patient’s arrival at the hospital.
