What is primary PCI in STEMI?

Primary percutaneous coronary intervention (PCI) refers to the strategy of taking a patient who presents with STEMI directly to the cardiac catheterization laboratory to undergo mechanical revascularization using balloon angioplasty, coronary stents, aspiration thrombectomy, and other measures.

When is PCI recommended for STEMI?

Guidelines recommend primary percutaneous coronary intervention (PCI) in patients with ST-segment–elevation myocardial infarction (STEMI) presenting ≥12 hours of symptom onset in the presence of ongoing ischemia.

When is primary PCI indicated?

Primary PCI is only indicated when symptoms duration is 12-24 hours (delayed presentation) if severe congestive heart failure, hemodynamic/electrical instability or continued angina is present. Primary PCI is not recommended when symptom onset is more than 12 hours and the patient is asymptomatic (OAT trial).

What is the difference between PCI and primary PCI?

Primary PCI for STEMI is a much higher risk procedure than PCI for stable patients or for non-STEMI acute patients. PPCI patients have a much higher rate than stable PCI patients of requiring a second visit to the cath lab for repeat procedure (after stent thrombosis), intra-aortic balloon pump insertion etc.

What is primary PCI and secondary PCI?

Primary PCI is the urgent use of PCI in people with acute heart attack, especially where there is evidence of heart damage on the electrocardiogram. PCI is also used in people after other forms of myocardial infarction or unstable angina where there is a high risk of further events.

How is primary PCI done?

Percutaneous Coronary Intervention (PCI) is a procedure to unblock a coronary artery. A catheter (a fine, flexible, hollow tube) with a small balloon at the end is inserted through an artery in the groin or arm. The balloon is directed to the blockage using X-ray guidance.

What is the advantage of primary percutaneous coronary intervention?

Primary percutaneous coronary intervention (P-PCI) significantly decreases mortality of patients presenting with ST elevation myocardial infarction (STEMI) and constitutes a type I A indication in the international clinical guidelines for the treatment of acute coronary syndrome (ACS).

Is PCI recommended treatment for STEMI?

There is general consensus that emergency percutaneous coronary intervention (PCI) is the preferred treatment for patients with ST-elevation myocardial infarction (STEMI), so long as it can be delivered in a timely fashion, by an experienced’ operator and cardiac catheterization laboratory (CCL) team.

What is difference between PTCA and PCI?

Percutaneous transluminal coronary angioplasty (PTCA) also called percutaneous coronary intervention (PCI) is a minimally invasive procedure to open blocked or stenosed coronary arteries allowing unobstructed blood flow to the myocardium.

For which problem is percutaneous coronary intervention PCI initially indicated?

Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a nonsurgical technique for treating obstructive coronary artery disease, including unstable angina, acute myocardial infarction (MI), and multivessel coronary artery disease (CAD).

What is the goal for PCI when treating a STEMI patient?

In the setting of acute ST-elevation myocardial infarction (STEMI), the primary goal of percutaneous coronary intervention (PCI) or fibrinolysis is to reestablish patency of the affected coronary artery and thereby improve perfusion of the myocardium.

What is door to balloon time for STEMI?

Based on the association between shorter times to reperfusion and lower mortality in patients with ST-segment–elevation myocardial infarction (STEMI),1,2 consensus guidelines recommend a door-to-balloon (D2B) time of 90 minutes or less for STEMI patients undergoing primary percutaneous coronary intervention (PCI).