PCI vs. Protected PCI: What is the Difference and Which One is Right for Me?

PCI vs. Protected PCI What is the Difference and Which One is Right for MeFirst Visit

Mr. Marx failed pre-operative screening for his gall bladder operation and was referred to a cardiologist for additional testing. He learned he had 3 blocked coronary arteries, which are blood vessels that supply the heart muscle with blood. The cardiologist suggested he might be a candidate for percutaneous coronary intervention. The doctor explained this procedure, but Mr. Marx was too upset to understand what this actually means.

Let’s explain:

Percutaneous coronary intervention—or PCI—is a nonsurgical procedure performed in the catheterization lab (cath lab) by an interventional cardiologist. The purpose of the procedure is to open up narrowed arteries using either a stent and/or balloon angioplasty.

During a balloon angioplasty, the interventional cardiologist uses a long, thin tube called a catheter that has a small balloon on its tip. The catheter is threaded through an artery in the leg which leads directly to the heart. Once in place, the balloon is inflated at the blockage site in the artery to flatten or compress the plaque against the artery wall.

During a stent procedure, a catheter is also inserted the same way by an interventional cardiologist. A stent is a small, mesh-like device. When a stent is placed inside of a coronary artery, it acts as a support or scaffold, keeping the vessel open. By keeping the vessel open, the stent helps to improve blood flow to the heart muscle. Stent procedures are usually used along with balloon angioplasty.

PCI is recommended for people with blocked coronary arteries who otherwise have a healthy heart.

Testing and Follow-up

After further testing and follow-up with his doctor, Mr. Marx was told that he has a low ejection fraction or reduced blood flow from the heart, and with his diabetes, peripheral vascular disease and history of chest pain, he is not a candidate for PCI or heart surgery. The heart team that his cardiologist referred him to has recommended a Protected PCI procedure. Now, he is looking for an explanation on a Protected PCI procedure and how it differs from the traditional PCI procedure.

Protected PCI is a PCI procedure performed with extra support from a heart pump. Mr. Marx does have blockages, but the risk of placing a stent or performing a balloon angioplasty may cause too much strain on his body, so he needs support from a device that can help pump for his heart. In his case, the heart pump can help maintain heart function, blood pressure, and blood flow, while the blockages in his coronary arteries are repaired.

Protected PCI is recommended for hemodynamically stable patients with a combination of severe coronary artery disease, a low ejection fraction, and other conditions such as diabetes, heart failure, advanced age, peripheral vascular disease, complex lesions, history of angina, or prior surgeries.

In summary, both PCI and Protected PCI are procedures that allow the narrowed coronary arteries of the heart to be opened and can lead to an improved quality of life due to easing of heart failure symptoms. The severity of your heart disease and other medical conditions will determine which procedure is recommended for you. Ask your cardiologist to discuss treatment options with you.

Learn more about the indications for use of PCI and Protected PCI. For more information about the Impella 2.5’s approved indications for use, as well as important safety, contraindication and warning information concerning the device, please visit http://abiomed.com/impella.

Next Steps:

About Impella

The Impella 2.5 system is a temporary (<6 hours) ventricular support device indicated for use during high risk percutaneous coronary interventions (PCI) performed in elective or urgent, hemodynamically stable patients with severe coronary artery disease and depressed left ventricular ejection fraction, when a heart team, including a cardiac surgeon, has determined high risk PCI is the appropriate therapeutic option. Use of the Impella 2.5 in these patients may prevent hemodynamic instability which can result from repeat episodes of reversible myocardial ischemia that occur during planned temporary coronary occlusions and may reduce peri- and post-procedural adverse events.

Protected PCI and use of the Impella 2.5 is not right for every patient. Patients may not be able to be treated with Impella if they have certain pre-existing conditions, which a cardiologist can determine, such as: severe narrowing of the heart valve, severe peripheral artery disease, clots in blood vessels, or a replacement heart valve or certain heart valve deficiencies. Additionally, use of Impella has been associated with risks, including, but not limited to valvular and vascular injury, bleeding, and limb ischemia in certain patients. Learn more about the Impella devices’ approved indications for use, as well as important safety and risk information at www.protectedpci.com/indications-use-safety-information/.