Coronary angioplasty and stenting (PCI)
A procedure to open a narrowed or blocked heart artery using a small balloon, usually leaving a tiny mesh tube (stent) behind to hold it open.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- PCI opens a narrowed heart artery and usually leaves a stent behind; it eases angina and can be life-saving in a heart attack.
- It treats one or more specific narrowings — it does not cure the underlying artery disease, so medicines and lifestyle still matter.
- Most people go home the same day or after one night for a planned procedure; recovery is usually quick, but longer after a heart attack.
- You must take your antiplatelet medicines (such as aspirin plus another blood-thinner) exactly as prescribed — stopping early sharply raises the risk of the stent clotting off.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Can relieve angina and breathlessness caused by a narrowed artery, often quite quickly
Disease pattern that is better treated with bypass surgery, for example several blocked vessels or particular anatomy.
You rest while the puncture site is watched for bleeding. With a wrist approach you can usually sit up and move sooner; with a groin approach you lie flat...
A clear, written medicines plan stating exactly how long each antiplatelet medicine continues.
You rest while the puncture site is watched for bleeding. With a wrist approach you can usually sit up and move...
Many people go home the same day or after one night. You will be told how to care for the wound and which...
Avoid heavy lifting, strenuous activity and driving for about a week after a planned procedure. Tiredness is...
Most people are back to normal activity. After a heart attack, a cardiac rehabilitation programme helps you build...
What is coronary angioplasty and stenting (PCI)?
Coronary angioplasty, often called PCI (percutaneous coronary intervention), is a way of opening a narrowed or blocked artery that supplies the heart muscle. It is done through a thin tube (catheter) passed in from the wrist or groin — it is a procedure, not open-heart surgery, so the chest is not opened.
A tiny balloon is guided to the narrowing and gently inflated to push the fatty build-up aside. In most cases a small expandable mesh tube called a stent is then left in place to hold the artery open. Most stents now used are 'drug-eluting' — coated with medicine that helps stop the artery narrowing again.
PCI can relieve angina (chest tightness on exertion) and, done urgently, can be a life-saving treatment during a heart attack. What it does not do is cure the underlying coronary artery disease. The rest of your arteries can still narrow over time, so medicines, and changes to things like smoking, weight, blood pressure and cholesterol, still matter.
Not every narrowing seen on a scan needs a stent. Sometimes medicines alone work just as well for stable symptoms, and a pressure-wire test (FFR) may be used to decide whether a borderline narrowing is actually limiting blood flow.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
PCI compared with other approaches for stable coronary disease
| Option | What it involves | Best suited to |
|---|---|---|
| PCI (stent) | Catheter procedure to open a narrowing | Symptoms from one or a few suitable narrowings |
| Medicines only | Tablets to ease angina and lower risk | Milder or stable symptoms; borderline narrowings |
| Bypass surgery (CABG) | Open-heart operation to reroute blood | Several vessels, or particular anatomy/diabetes |
The right choice depends on your symptoms, which arteries are affected and your overall health. A heart team sometimes discusses complex cases. This is a guide, not advice — your cardiologist will explain what fits you.
Preparing for your procedure
- See the cardiologist who will do the procedure; ask whether it is being done to ease symptoms, to lower risk, or both.
- Bring a full list of your medicines. You will be told which to keep taking and whether any (for example some diabetes or blood-thinning medicines) need adjusting.
- Tell the team about any allergy to the X-ray contrast dye, or any kidney problems, as the dye can affect the kidneys.
- You may be asked not to eat for a few hours beforehand; follow the instructions you are given.
- Arrange a lift home and someone to stay with you, as you should not drive straight afterwards.
- If you smoke, stopping helps your heart and healing; ask for support if you need it.
- Ask whether a wrist (radial) or groin (femoral) approach is planned, and what aftercare each involves.
What happens
You stay awake for a planned procedure. Local anaesthetic numbs the skin at your wrist or groin, and sometimes you are given light sedation to help you relax. You should not feel the catheter moving through the arteries.
Using X-ray pictures and contrast dye, the cardiologist guides a fine tube to the narrowed part of the artery. A small balloon is inflated to open it, and in most cases a stent is placed to keep it open. You may feel a brief twinge of your usual chest symptoms as the balloon inflates.
The procedure usually takes between half an hour and two hours. Afterwards the tube is removed and pressure or a small plug is used to seal the artery. If the wrist was used you can often sit up and move about sooner; the groin route needs you to lie flat for a few hours.
For an emergency PCI during a heart attack, the same steps happen quickly, and you will normally stay in hospital afterwards for monitoring and recovery.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Disease pattern that is better treated with bypass surgery, for example several blocked vessels or particular anatomy.
- A borderline narrowing that a pressure-wire (FFR) test shows is not limiting blood flow — a stent may add risk without benefit.
- Someone who cannot safely take the required antiplatelet medicines after the procedure.
- Very advanced kidney disease where the contrast dye poses a high risk without careful planning.
Delay or rearrange if…
- Active infection or another acute illness that can be treated first (for a planned procedure).
- Poor kidney function that should be reviewed and optimised before contrast dye is used.
- Important blood-thinning or other medicines that need adjusting beforehand.
- Uncontrolled bleeding risk, or anaemia, that should be addressed first.
- An emergency PCI for a heart attack is the exception — it should not be delayed.
Alternatives to discuss
- Medicines alone (anti-anginal and heart-protection tablets) for stable or milder symptoms.
- Coronary artery bypass surgery (CABG) for more widespread disease.
- Watchful management with risk-factor control and cardiac rehabilitation.
- A pressure-wire (FFR) assessment first, to decide whether any stent is needed at all.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Can relieve angina and breathlessness caused by a narrowed artery, often quite quickly
- Done urgently during a heart attack, can restore blood flow and limit damage to the heart muscle
- Avoids open-heart surgery for many people, with a shorter recovery
- Lets the team treat the specific narrowing causing problems
- A pressure-wire (FFR) check can confirm a borderline narrowing is worth treating, avoiding unnecessary stents
Risks & complications
- Bruising, bleeding or a tender lump where the tube went in (wrist or groin)
- A brief return of your usual chest discomfort as the balloon is inflated
- Feeling tired for a day or two afterwards
- Damage to the artery at the wrist or groin where the tube was inserted
- Allergic reaction to the X-ray contrast dye
- Reduced kidney function from the contrast dye, usually temporary
- The need for a longer hospital stay than planned
- The stent suddenly clotting off (stent thrombosis), which can cause a heart attack
- A heart attack, stroke, or serious bleeding needing a transfusion
- Damage to a heart artery needing urgent further treatment or surgery
- Death — very rare for a planned procedure, higher in an emergency or when very unwell
Your personal risk depends a lot on your age, kidney function, how many arteries are affected and whether this is planned or an emergency. The single most important thing you can do to stay safe afterwards is take your antiplatelet medicines exactly as prescribed — stopping them early greatly raises the chance of the stent clotting off. Ask your cardiologist what your own risk is and exactly how long you must stay on each blood-thinning medicine.
Published figures to discuss
Complication rates depend heavily on whether the procedure is planned or an emergency, your age, kidney function and how complex the disease is. Published figures are mostly from research series and audits, so treat them as a guide rather than your personal risk, which your cardiologist can estimate.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Major complication during a planned procedure | Usually under about 1 in 100 (less than 1%), per BHF patient information | Higher when done as an emergency or in people who are very unwell or have complex disease. | NHS — Coronary angioplasty: risksnhs.ukPublished figure |
| Stent suddenly clotting off (stent thrombosis) | About 1 in 100 in NHS patient information | Risk rises sharply if antiplatelet medicines are stopped too early; can cause a heart attack. | NHS — Coronary angioplasty and stent insertionnhs.ukPublished figure |
| Bleeding or bruising from the access site | Common for minor bruising; serious bleeding is less common | Risk varies with radial vs femoral access, anticoagulants, age and kidney function. | NHS — Coronary angioplasty: risksnhs.ukSource-linked context |
| Restenosis or need for repeat treatment | Recognised despite modern drug-eluting stents | Recurrent angina after PCI should be reassessed rather than assumed to be anxiety or indigestion. | Guide sourcesClinical context |
| Contrast kidney injury | Uncommon in low-risk patients; higher with chronic kidney disease, diabetes, dehydration or large contrast volumes | Pre-procedure kidney tests, hydration planning and contrast minimisation reduce risk. | NHS — Coronary angioplasty: risksnhs.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Recovery from a planned PCI is usually quick — the access point at the wrist or groin needs a little care, and the main task is settling back into normal life while your medicines do their job. Recovery after an emergency PCI for a heart attack takes longer and includes cardiac rehabilitation.
- Bruising, mild soreness or a small lump at the wrist or groin that settles over a week or two
- Feeling tired or a little flat for a few days
- An aching wrist or arm if the wrist route was used
- Reassurance that some chest awareness can occur early on — but new or ongoing chest pain should be reported
Aftercare
- Take aspirin and your second antiplatelet medicine exactly as prescribed, and do not stop them without your cardiologist's advice.
- Keep the wound area clean and dry, and watch for swelling, increasing pain or bleeding.
- Drink normally to help your kidneys clear the contrast dye, unless you have been told to limit fluids.
- Avoid heavy lifting and strenuous activity for about a week after a planned procedure.
- Do not drive until you are told it is safe — usually at least a week after a planned procedure, longer after a heart attack.
- Go to cardiac rehabilitation if you are offered it after a heart attack.
- Keep follow-up appointments and know who to call if you have concerns.
- All discharge medicines collected, with the dates each should continue until
- Written instructions on wound care for the wrist or groin
- A lift home and someone to stay with you the first night
- Time off work booked (about a week for a planned procedure)
- Cardiac rehabilitation contact details if offered
- The hospital or out-of-hours number saved for urgent concerns
- A clear plan for who manages your blood pressure, cholesterol and other risk factors
Scars and how they heal
There is no surgical scar. You are left with a small puncture site at the wrist or groin, which usually heals to a tiny mark. Bruising around it is common and fades over a week or two. A wrist site may feel tender for a while.
⚠ Get urgent help if…
- Chest pain like your original symptoms, especially if it does not ease — this can mean the stent has clotted off; call 999
- Sudden severe chest pain, breathlessness, sweating or collapse — call 999
- Signs of a stroke: face drooping, arm weakness or slurred speech — call 999
- Heavy or uncontrolled bleeding from the wound site — apply firm pressure and get urgent help
- A rapidly swelling, very painful or cold, pale hand or leg on the side used
- Fever, spreading redness, heat or discharge from the wound (signs of infection)
- Much less urine, or feeling very unwell, in the days after the procedure
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result means the narrowed artery is opened and blood flows freely again, often easing angina or breathlessness within days. After an emergency PCI, reopening the artery quickly can limit heart-muscle damage.
What PCI cannot do is stop coronary artery disease developing elsewhere. The stented segment can occasionally narrow again, and other arteries can narrow over time. That is why your medicines and risk-factor control are as important as the procedure itself, and why new or returning chest symptoms should always be checked.
Modern drug-eluting stents stay in place permanently and most keep the artery open for years. A minority of arteries narrow again inside the stent (restenosis), and a small number can clot off, particularly if antiplatelet medicines are stopped too soon. The disease in the rest of your arteries continues, so long-term medicines and lifestyle changes are what protect you over time.
Related tests, treatments or support
PCI is often done at the same sitting as the diagnostic angiogram that finds the narrowing, and a pressure-wire (FFR) check may be used first to decide whether a borderline narrowing needs treating. People treated for a heart attack are usually started on several heart-protection medicines and offered cardiac rehabilitation.
Follow-up & long-term care
You will normally be reviewed after the procedure and given a clear medicine plan, including how long to stay on each antiplatelet medicine. After a heart attack, follow-up usually includes cardiac rehabilitation and ongoing management of blood pressure, cholesterol and other risk factors, often shared with your GP.
- Take all prescribed antiplatelet and heart-protection medicines for as long as advised
- Attend cardiac rehabilitation if offered, and build up activity safely
- Keep blood pressure, cholesterol, weight and (if relevant) diabetes well controlled
- Stop smoking and limit alcohol
- Report any return of chest symptoms promptly rather than waiting
Repeat, follow-on and what comes next
- A minority of stented arteries narrow again inside the stent (restenosis) and may need repeat treatment.
- Other arteries can narrow over time, so further procedures are sometimes needed years later.
- Some people are advised to have bypass surgery instead if PCI is not durable enough for their disease.
- A pressure-wire check beforehand can reduce the chance of fitting a stent that was not needed.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear, written medicines plan stating exactly how long each antiplatelet medicine continues.
- A named contact and instructions on what to do if chest pain returns.
- Cardiac rehabilitation offered after a heart attack.
- Shared follow-up with your GP for blood pressure, cholesterol, diabetes and stopping smoking.
- Prompt review of any returning symptoms rather than waiting for a routine appointment.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether it is a single narrowing or a more complex, multi-vessel procedure
- The cardiologist's (operator's) fee and the cath-lab/facility fee
- The number and type of stents and other devices used
- Whether a pressure-wire (FFR) or imaging such as intravascular ultrasound is used
- Any sedation, and the length of hospital stay
- Follow-up appointments and ongoing medicines
- What happens if a complication needs extra care or a longer stay
- The cardiologist's fee and the cath-lab/facility fee
- The cost of stents, balloons and any pressure-wire or imaging used
- Sedation costs, if used, and any overnight stay
- Follow-up appointments and who manages your medicines afterwards
- Which heart-protection medicines you will need and whether they are included
- The cancellation policy
- What happens, and what it costs, if a complication or longer stay is needed
On the NHS? Coronary angioplasty is widely provided by the NHS when clinically indicated, including as emergency treatment for a heart attack; private care is usually used for speed, convenience or choice of cardiologist for stable symptoms.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being given a stent for a borderline narrowing without a pressure-wire (FFR) check or a discussion of medicines alone.
- Not being told clearly how long the antiplatelet medicines must continue, or why stopping early is dangerous.
- No discussion of bypass surgery as an alternative where it might suit better.
- Treating PCI as a 'cure' rather than treatment of specific narrowings within ongoing disease.
- No clear written plan for what to do if chest pain returns.
Marketing red flags
- Language suggesting a stent 'fixes' or 'cures' heart disease.
- Pressure to stent every narrowing seen, without functional testing or discussion of alternatives.
- Downplaying the importance of long-term antiplatelet medicines.
- Implying a quick procedure removes the need for lifestyle change or other medicines.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Is this procedure mainly to relieve my symptoms, to reduce my risk, or both?
- Would medicines alone, or bypass surgery, be a reasonable option for me instead?
- Will you use a wrist or groin approach, and why?
- Exactly which blood-thinning medicines must I take, and for how long?
- What is my personal risk of a serious complication?
- What should I do, and who do I call, if my chest pain comes back?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is angioplasty the same as open-heart surgery?
Will a stent cure my heart disease?
How long do I need to take the blood-thinning tablets?
When can I drive again?
Can I have PCI on the NHS or only privately?
What if a narrowing is borderline — do I still need a stent?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Coronary angioplasty and stent insertion NHS — Coronary angioplasty: risks NHS — Coronary angioplasty: recovery British Heart Foundation — Coronary angioplasty and stents DVLA — Cardiovascular disorders: assessing fitness to drive DVLA — Assessing fitness to drive (medical guidance) DVA Northern Ireland — Telling the DVA about a medical condition
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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