PCI Consent 🫀
Consent guide for PCI (percutaneous coronary intervention). Procedure explanation, risks, benefits, alternatives, and patient information for obtaining informed consent.
🔍 Procedure
- Percutaneous Coronary Intervention (PCI), also known as coronary angioplasty with or without stent insertion.
💡 Indications
- Treatment of significant coronary artery stenosis causing angina or acute coronary syndrome (ACS)
- Primary treatment for STEMI (primary PCI)
- Elective management of stable ischaemic heart disease
🧾 Procedure Walkthrough
- You will be brought to the cardiac catheterisation lab and connected to heart and oxygen monitors.
- A cannula is placed, and local anaesthetic is used at the wrist or groin.
- A catheter is inserted and guided to the heart. Contrast dye is used to visualise the coronary arteries under X-ray.
- If a blockage is found, a balloon may be inflated to open the artery, and a stent is inserted to keep it open.
- Mild burning or discomfort in the wrist is common. The procedure takes 30–90 minutes.
- Radiation and iodine contrast are used—risks are discussed in advance.
⚠️ Risks & Complications
- Common: bruising, bleeding, discomfort at puncture site.
- Occasional: blood vessel spasm, allergic reaction to contrast, arrhythmias.
- Rare: heart attack, stroke, damage to artery or heart, pseudoaneurysm, infection, kidney impairment.
- Very rare: death (<0.5% in elective PCI).
- Emergency surgery may be required in rare cases.
💬 Common Patient Questions
- Will I be awake? — Yes, usually under local anaesthetic with sedation available if needed.
- How long does it take? — Around 30–90 minutes, depending on complexity.
- When can I go home? — Often same day or next day, unless complications or ongoing symptoms.
- Will I need more procedures? — Possibly, depending on coronary disease severity.
- Do I need medications after? — Yes, dual antiplatelet therapy (e.g. aspirin + clopidogrel) is typically needed for months.
✅ Benefits
- Relieves angina and improves quality of life
- Restores blood flow in acute MI (reduces mortality)
- Minimally invasive alternative to bypass surgery in selected patients
🔄 Alternatives
- Medical therapy alone (beta-blockers, nitrates, statins)
- Coronary artery bypass grafting (CABG)
- Lifestyle changes + risk factor optimisation
🧠 Special Considerations
- Discuss blood thinning medications—some may need to be continued, others paused.
- Ensure renal function is checked (due to contrast use).
- Inform team of pregnancy, allergies, or previous contrast reactions.
- Patients should not drive, make important decisions, or use heavy machinery for 24 hours post sedation.
- You may require bed rest for 3–5 hours after depending on the access site.
- Trainees may assist under supervision. Separate consent needed for photos or recordings.
🗣️ Example Consent Script
- "We’re recommending a PCI—this means using a small balloon and possibly placing a stent to open a narrowed heart artery."
- "It’s done via a tube inserted into the wrist or groin under local anaesthetic and X-ray guidance."
- "Common risks include bruising or bleeding; rare risks include heart attack or stroke. Let us know about allergies or if you're pregnant."
- "You may go home the same day or stay overnight depending on your recovery. Do you have any questions?"