Coronary Angioplasty & Stents (PCI)

Angioplasty (percutaneous coronary intervention, PCI) is offered when a significant narrowing or blockage has been found in a heart artery — usually on a coronary angiogram or CT scan — and treating it will relieve your symptoms or protect your heart. Common reasons include angina that limits your life despite medication, a heart attack (where emergency angioplasty to reopen the artery is life-saving), or a narrowing that needs treating before another procedure such as TAVI. In many cases, PCI is carried out during the same procedure as the diagnostic angiogram.

Angioplasty is a keyhole procedure to open a narrowed or blocked heart artery. A very fine wire is advanced across the narrowed segment. A small balloon is then passed over the wire and inflated, compressing the plaque against the artery wall to restore blood flow. A stent — a small tubular metal mesh — is then implanted to hold the artery open permanently. Modern drug-eluting stents release medication over time that helps prevent the artery re-narrowing.

The procedure is performed under local anaesthetic, usually through the wrist, and typically takes 45–90 minutes. You may feel brief chest tightness during balloon inflation — this is expected and settles within seconds.

Not every narrowing needs a stent, and every stent that is implanted should be implanted perfectly. 

I use additional techniques routinely, not selectively: Pressure-wire measurements (FFR/iFR) confirm whether a narrowing is genuinely restricting blood flow before it is treated, avoiding unnecessary stents. Intravascular imaging (IVUS/OCT) provides high-resolution pictures from inside the artery, allowing the stent to be sized accurately and the final result to be checked — an approach shown in clinical trials to improve long-term outcomes. For heavily calcified arteries that standard balloons cannot open, we use calcium-modification advanced techniques such as intravascular lithotripsy. 

Angioplasty relieves angina, improves exercise capacity and quality of life, and in the setting of a heart attack saves lives and protects heart muscle. It is a very commonly performed and safe procedure. Bruising at the wrist or groin is relatively common and settles on its own; serious complications — including heart attack, stroke, damage to the artery or the need for emergency surgery — are rare. We will discuss your individual risks and expected benefits in clinic and provide written information to help you make an informed choice.

Most patients go home the same day or after one night. With the wrist approach, you can usually return to normal activities within a day or two, avoiding heavy lifting with that arm for about a week. Desk-based work is usually possible within a couple of days; driving is usually possible after about a week following planned angioplasty (longer after a heart attack), in line with DVLA guidance.

After stenting, you will take dual antiplatelet therapy — aspirin plus a second blood-thinning medication — for a period tailored to your circumstances, alongside review of requirement for long-term treatment for blood pressure and cholesterol - to lower risk of any future narrowing. The stent treats the narrowing; prevention protects your future, so every patient receives a clear written aftercare and prevention plan.

No — once implanted, the stent cannot be felt. It becomes incorporated into the artery wall within weeks and is permanent. Modern stents are MRI-safe and do not set off airport scanners. Re-narrowing rates with current drug-eluting stents are low, and taking your medication as prescribed is the most important protection.

Occasionally, angiography shows disease that is better treated with bypass surgery. If so, we will discuss this openly and refer you to a cardiac surgeon through the Heart Team — ensuring you receive the right treatment for you, not simply the available one.

Dr Demir is a Consultant Interventional Cardiologist practising at leading Private London Hospitals, with advanced  training in coronary and structural intervention in London & Milan. He performs  coronary procedures regularly, operates radial-first, and uses pressure-wire assessment routinely to ensure treatment decisions are precise, evidence-based and tailored for each patient.

Dr Demir is one of the consultants delivering  emergency heart attack service at the Essex Cardiothoracic Centre, one of the busiest heart attack centres int he UK. He is member of team providing immediate angioplasty for patients with acute ST elevation myocardial infarction.

Contact Ms Amelia Garner (PA) on 020 3198 9826 or drozandemir.sec@outlook.com to arrange a consultation.