Percutaneous Coronary Intervention (PCI)

Catheter-based diagnosis and treatment of coronary artery disease — angiography, angioplasty, and stent placement. The dominant interventional cardiology procedure globally. Usually performed in a dedicated cardiac cath lab, though some complex cases (TAVR, structural heart) move to hybrid ORs.

Clinical pathway

1. Vascular access — radial (default in most centers) or femoral.
2. Diagnostic angiography — contrast injected into coronary arteries via guiding catheter; fluoroscopic cineangiograms show stenoses and their severity.
3. Lesion assessment — visual + functional (FFR pressure wire, iFR, OCT, IVUS) in many cases.
4. Intervention if indicated — balloon angioplasty + drug-eluting stent deployment. Sometimes rotational atherectomy first for calcified lesions.
5. Final angiography — confirm result, document for report.

Typical systems

• Philips Allura Xper FD10 (single-plane, legacy)
• Philips Azurion 7 (current)
• Siemens Artis Q
• GE Innova 2100-IQ

Room + procedure characteristics

• Procedure time: 30–90 min routine; longer for complex multi-vessel, CTO, bifurcation
• Room requirements: cath lab with radiolucent table, hemodynamic monitoring, contrast injector, crash cart + emergency capacity
• Team: interventional cardiologist + cath tech + RN + scrub nurse
• Fluoroscopy dose: variable; DAP tracked per procedure, reported in dose registry

Dose considerations

Dose-Area Product is the regulatory metric. Long PCI cases (CTO, complex bifurcation) can deliver clinically meaningful patient dose + significant occupational dose to operators. ClarityIQ-equipped systems (Azurion, Allura Clarity) meaningfully reduce both.

Related

• Diagnostic Cardiac Catheterization
• TAVR (structural heart adjacent)
• EP Ablation (adjacent, different lab)