Complex Percutaneous Coronary Intervention (PCI)
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About our Complex Percutaneous Coronary Intervention (PCI) service
Percutaneous Coronary Intervention (PCI), also known as coronary stenting or angioplasty, is used to improve blood flow to the heart muscle by treating narrowed or blocked coronary arteries. Complex Percutaneous Coronary Intervention refers to stenting procedures that are more challenging or higher risk than standard PCI, often requiring advanced techniques and specialised equipment that are not available in all centres.
The Complex PCI service at Mater Private Network is a dedicated, consultant-led service for patients with complex patterns of coronary artery disease. We perform complex PCI procedures on a weekly basis, with many of the procedures performed with two consultants working together in the cath lab (operating theatre). The dedicated complex PCI list has been developed to try to minimise risk and ensure that each procedure can be carried out as safely and efficiently as possible. Our highly experienced team performs large numbers of these complex PCI procedures annually.
Understanding Complex PCI
Complex PCI is used to treat complex patterns of coronary artery disease, the build-up of plaque in the arteries that supply the heart muscle. This includes left main coronary artery lesions, heavily calcified lesions, bifurcation lesions, multi-vessel disease and chronic total occlusions. The service also treats patients who develop recurrent issues after previous coronary stenting (in-stent restenosis) or coronary artery bypass surgery (graft failure).
Some patients referred to the service have previously been told that their heart condition cannot be treated because it is too complex or too high risk. Our Complex PCI service aims to give these patients a viable treatment pathway and to restore them back to good health.
Conditions we treat
- Left main coronary artery disease
- Heavily calcified coronary lesions
- Bifurcation lesions
- Multi-vessel coronary artery disease
- Chronic total occlusions
- In-stent restenosis following previous stenting
- Graft failure following coronary artery bypass surgery
If you are looking for a second opinion, or have been told your condition is too complex or high-risk to treat, our team may still be able to help.
What to expect
Patients may be referred by their GP or cardiologist, or may self-refer to our service in order to seek a second opinion on their heart condition.
Once referred, patients are reviewed by a member of the Complex PCI team to understand the relevant details of their case. Where a patient has had previous angiograms, stenting or bypass surgery, the team will request further detail on these procedures, and an updated coronary angiogram is often required to assess the current status of their coronary arteries.
Following this assessment, the team will discuss a management plan with the patient. This will usually involve scheduling a complex PCI procedure to improve blood supply to the heart muscle.
Our team
The Complex Percutaneous Coronary Intervention service in Dublin is led by Dr. Colm Hanratty, Director of the Cardiac Catheterisation Lab at Mater Private Network Dublin. Dr. Hanratty is joined by his Consultant Interventional Cardiologist colleagues Dr. JJ Coughlan and Dr. Rory Durand in running a weekly complex PCI operating list. Several other members of the Mater Private Network cardiology team also specialise in and perform complex PCI procedures.
In our Cork hospital, the Complex PCI service is led by Dr. Simon J. Walsh, Director of the Cardiac Catheterisation Lab at Mater Private Network Cork. He delivers this service in conjunction with several of his interventional colleagues who also perform complex PCI procedures.
How to access this service
To be seen by a member of the Complex Percutaneous Coronary Intervention team, contact us by email and an appointment will be arranged.
Our consultants in Dublin
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Our consultants in Cork
Frequently Asked Questions
This service is for patients presenting with complex patterns of coronary artery disease, including those with recurrent issues after stenting or bypass surgery, or chronically blocked arteries. These patients often experience symptoms that affect their quality of life, such as chest pain or tightness, shortness of breath, and fatigue or reduced exercise tolerance. The service aims to improve blood flow to the heart muscle to relieve these symptoms and improve their quality of life.
Complex PCI can be performed safely and effectively by specialised teams experienced in these procedures. We continuously audit clinical outcomes and perform complex PCI procedures with extremely low complication rates. To optimise safety and efficiency, many complex and high risk PCI procedures are carried out on a dedicated two-consultant operating list – which means two consultants operating side by side, simultaneously, to carry out the procedure.
Our service specialises in treating patients who have previously been told that nothing can be done. In the vast majority of cases, the team can come up with a treatment strategy to restore blood flow to the heart muscle and improve patients' symptoms and quality of life.
There is no single accepted definition of complex PCI. However, several patient groups are commonly treated, including: patients with severe calcification of the arteries, patients with arteries that are completely blocked (chronic total occlusions), and patients who develop recurrent issues following stenting (restenosis) or bypass grafting surgery (graft failure). In some cases, the pattern of disease or the patient's individual characteristics can make the risk associated with PCI higher, and the service also specialises in treating these patients. A comprehensive range of interventional techniques are available to the complex PCI team, allowing us to manage high degrees of complexity safely and effectively.
