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Cardiolucent

Treatment

Cardiac Catheterization / Angioplasty (PCI)

Catheter-based diagnosis and treatment of coronary artery disease.

Cardiac catheterization is a minimally invasive procedure that allows direct visualization of the coronary arteries using contrast dye and X-ray imaging. When a significant blockage is found, percutaneous coronary intervention (PCI) — commonly called angioplasty with stenting — can be performed in the same setting or a follow-up procedure to restore blood flow. PCI is the standard of care for acute heart attack, and for selected stable coronary disease where symptoms persist despite optimized medical therapy or where anatomy poses high risk. Dr. Kedan evaluates the indication, coordinates the procedure at Cedars-Sinai with interventional colleagues, and provides the longitudinal cardiology care that follows.

What This Treatment Approach Includes

  • Non-invasive evaluation first — stress testing or coronary CT angiography to define need
  • Coronary calcium scoring and advanced lipid panel when risk stratification is uncertain
  • Pre-procedure planning: anticoagulation, kidney function optimization, anesthesia clearance
  • Coordination with Cedars-Sinai interventional cardiology for catheterization and PCI
  • Choice of access site (radial preferred when feasible) and stent type
  • Post-procedure dual antiplatelet therapy duration plan
  • Secondary prevention plan — statin, blood pressure control, cardiac rehab referral

How It Works

During catheterization, a thin catheter is advanced through the radial artery in the wrist (or femoral artery in the groin) to the coronary arteries, where contrast dye is injected and X-ray images reveal any blockages. If a significant lesion is identified, a balloon catheter is advanced across the narrowing and inflated to compress the plaque, after which a drug-eluting stent is deployed to keep the artery open. Modern stents release medication that prevents re-narrowing and reduces the risk of stent thrombosis.

Who This Is For

  • Acute heart attack — emergency PCI is standard of care for ST-elevation myocardial infarction
  • Non-ST elevation acute coronary syndrome based on risk stratification
  • Stable coronary disease with symptoms despite optimized medical therapy
  • High-risk anatomy on non-invasive imaging (left main, three-vessel disease, proximal LAD)
  • Heart failure with suspected ischemic etiology requiring confirmation
  • Restenosis or progression after prior PCI
  • Diagnostic catheterization to confirm or exclude obstructive coronary disease before other procedures

Monitoring and Follow-Up

After PCI, dual antiplatelet therapy duration is set at the time of stent placement and tracked carefully — typically several months to a year depending on stent type, bleeding risk, and ongoing ischemic risk. Follow-up includes blood pressure and lipid optimization, repeat imaging only when symptoms recur, and cardiac rehabilitation enrollment. Dr. Kedan provides the longitudinal follow-up, with same-day access for new chest pain or other concerning symptoms.

How Cardiolucent Manages This

The decision to pursue catheterization and PCI for stable disease is nuanced — many patients do equally well with optimized medical therapy alone, and the procedure is most clearly beneficial in specific anatomic and clinical scenarios. Dr. Kedan reviews the data with you in extended visits before referral, coordinates the procedure timing with Cedars-Sinai, and remains the continuity cardiologist before, during, and after. POCUS at office visits and same-day labs support the post-procedure care.

Common Questions

Frequently Asked Questions

What is the difference between cardiac catheterization and PCI?
Cardiac catheterization is the diagnostic procedure — advancing a catheter to the coronary arteries and injecting contrast to visualize blockages. PCI (percutaneous coronary intervention), also called angioplasty with stenting, is the therapeutic procedure performed when a significant blockage is found, using a balloon and stent to open the artery.
Who needs PCI?
PCI is the standard of care for acute ST-elevation heart attack and is used in higher-risk acute coronary syndromes. For stable coronary disease, PCI is appropriate when symptoms persist despite optimized medical therapy or when anatomy (left main, proximal LAD, three-vessel disease) poses elevated risk. Many patients with stable disease do equally well on optimized medical therapy alone.
What is the difference between a stent and a balloon angioplasty alone?
Balloon angioplasty without a stent has been largely replaced because the artery often re-narrows. Modern drug-eluting stents release medication that prevents re-growth of tissue inside the stent, with significantly better long-term patency than bare-metal stents or balloon alone. Stent type is selected based on lesion location, anatomy, and bleeding risk.
What are the main risks?
The procedure is generally safe but carries small risks of bleeding at the access site, kidney injury from contrast dye, arrhythmia, coronary artery dissection or perforation, heart attack, stroke, and rarely the need for emergency bypass surgery. Risks are higher in patients with kidney disease, complex anatomy, or critical illness. The interventional cardiologist reviews specifics.
How long is recovery after PCI?
Most patients are discharged the same day or after one night and resume light activity within a few days, with restrictions on heavy lifting for about a week. Cardiac rehabilitation is encouraged starting within several weeks and significantly improves recovery and long-term outcomes.
What medications will I need after a stent?
Dual antiplatelet therapy (aspirin plus a P2Y12 inhibitor such as clopidogrel, ticagrelor, or prasugrel) is required for a defined period — typically several months to a year depending on the clinical setting. Statin therapy at high intensity, blood pressure optimization, and other secondary-prevention medications continue indefinitely.
What is the difference between PCI and bypass surgery (CABG)?
PCI is a catheter-based procedure performed without opening the chest. Bypass surgery (CABG) is open-chest surgery in which arteries or veins are used to route blood around blockages. For most patients with one- or two-vessel disease, PCI is appropriate. For complex multivessel disease, diabetic patients with multivessel disease, or significant left main disease, CABG may offer better long-term outcomes. The decision involves a heart team review.
Will I need future procedures?
Stents have excellent long-term patency, but coronary disease is a systemic process — new lesions can develop elsewhere over time. Aggressive secondary prevention (statin, blood pressure, lifestyle, antiplatelet) is what protects you from future events. Repeat catheterization is performed only when symptoms recur, not on a routine schedule.
What lifestyle changes matter most after PCI?
Smoking cessation (the single most impactful intervention), regular aerobic exercise, a Mediterranean or DASH diet, weight management, and tight blood pressure and cholesterol control. Cardiac rehabilitation enrollment is associated with significantly better outcomes and is encouraged for nearly every patient.
How do I start a catheterization evaluation with Dr. Kedan?
Schedule a consultation at the Beverly Hills office with any prior stress tests, EKGs, and imaging. Cardiolucent is a concierge practice and does not bill Medicare or insurance, though a detailed superbill is provided for out-of-network reimbursement. The procedure itself is performed at Cedars-Sinai. Call (310) 304-5555 or use the contact form.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.