Coronary Angioplasty & Stenting

Coronary angioplasty and stenting — collectively referred to as percutaneous coronary intervention (PCI) — is the most frequently performed cardiac procedure worldwide, restoring blood flow through narrowed or blocked coronary arteries using a catheter-based approach that avoids open-heart surgery. At SilverOak Health, our interventional cardiologists perform both elective PCI for stable angina and emergency primary PCI for ST-elevation myocardial infarction (STEMI), with door-to-balloon times consistently within 60 minutes for STEMI patients — meeting the most stringent international targets.

The procedure is performed via radial or femoral arterial access under local anaesthesia. A guide catheter is advanced to the coronary ostium, through which a guidewire is carefully navigated past the coronary stenosis. A balloon catheter is then advanced over the wire and inflated to compress the plaque and dilate the vessel — a process called angioplasty. A drug-eluting stent is then deployed at the lesion site, providing a scaffold that maintains luminal patency and releases anti-proliferative medication to prevent in-stent restenosis.

Modern drug-eluting stents have reduced restenosis rates to below 5% at one year, making PCI a highly durable revascularisation strategy for most single and multivessel disease patterns. Intravascular imaging with optical coherence tomography (OCT) or intravascular ultrasound (IVUS) is used routinely for complex lesions to guide optimal stent sizing, positioning, and expansion, improving long-term outcomes. Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) physiological assessment guides the decision to intervene in intermediate coronary lesions, avoiding unnecessary stenting where haemodynamic significance is absent. Our patients receive post-procedure dual antiplatelet therapy education and structured cardiac follow-up to ensure optimal secondary prevention.