Can virtual angiography be performed on every patient?
With the developments in medical technology reflected in imaging methods, early diagnosis of cardiovascular diseases is now possible. However, many things are misunderstood about “Virtual Angiography” (Computed Tomographic Angiography), which has been frequently mentioned in recent years. Anadolu Health Center Cardiology Specialist Dr. Gürsel Ateş explains virtual angiography…
What is virtual angiography?
While a certain amount of contrast material is administered through the arm vein, thin-section images taken from the heart by computerized tomography (CT) are simultaneously viewed and evaluated in a digital environment, and the coronary vessels are visualized and evaluated.
How is virtual angiography performed?
The procedure is performed as if applying a serum from the arm; The vein is entered in the arm. Virtual coronary angiography is performed in two stages. In the first stage, direct imaging is performed without administering contrast material to show the calcification in the heart vessels. Calcifications that may occur in the vessels are evaluated mathematically from the images taken.
What is the difference between virtual angiography and normal angiography?
If the calcification in the patient’s heart vessels is below certain values, the contrast agent is then administered intravenously. This is the difference from normal angiography. Cross-sectional images are taken on the computer. These sections are then displayed in three dimensions on a computer. The important thing in this process is to take images of the blood as it passes through the heart vessels. In order to create a full heart image, images recorded in several heartbeats must be combined on a computer.
How long does it take to complete virtual angiography?
The process of performing virtual angiography is actually very short. Images are completed in as little as 6-24 seconds. The most important thing for the procedure is the preparation of the patient. In order for the procedure to be performed, the heartbeat must be around 60/min. If the patient’s heart rate is at this level, the imaging process can be completed immediately. Patients with a heart rate above 60/min are given heart-slowing medications orally and/or intravenously, and the procedure is completed after the patient’s heart rate drops to the desired levels. It may take a long time to achieve this in some patients.
What are the side effects of virtual angiography? Is it harmful?
The most important benefit of virtual angiography is that there is no need to perform classical angiography. During virtual angiography, the patient receives some radiation and the opaque substance given during the procedure can create a burden on the kidney. For this reason, virtual angiography is not a method that can be repeated frequently. Virtual angiography needs to be performed on the appropriate patient and at the appropriate time.
Who can undergo virtual angiography?
If the patient’s stress test is problematic, the patient is under 40-50 years old and has chest pain, etc. If there are complaints, it may be suitable for virtual angiography. There is a group in which the stress test is neither problematic nor clear, and a further examination in this group needs to show whether there is a problem with the veins. Virtual angiography is not recommended for people who do not have any problems as a result of the stress test applied to the patient. There are two suspicious groups: Patients whose exercise test results show that there is a problem, and patients whose exercise test results show that there is no problem. If virtual angiography is performed on a patient who is likely to be sick in this group, a problem may occur. As a result, if the probability of disease is very high, the possibility of coronary angiography after virtual angiography is also very high. Thus, unnecessary action is taken.
Who are the ones who are likely to have problems with virtual angiography?
The results are likely to be problematic in people with high cardiac risk factors, such as people with long-term diabetes, hypertension and high cholesterol levels, and in patients over the age of 50. People who have previously been diagnosed with coronary artery disease are more likely to have problematic virtual angiography results.
Can virtual angiography be performed regularly (routinely)?
There are examples of false news stating that virtual angiography is a must for everyone who does sports or that businessmen have regular virtual angiography.
Virtual angiography is not a method used to determine heart risk. If we look at it as a businessman, if the stress test is clean and there is no complaint such as chest pain, there is no point in performing a virtual angiography. Because the method is not used for risk control, but to determine whether coronary artery disease exists or whether existing coronary artery disease requires intervention.
If the person’s stress test results are bad but the probability of getting sick is low, then virtual angiography can be performed. But if the stress test is negative and the patient has no significant complaints, then there is no point in performing virtual angiography on this patient. As a result, this method also has certain risks. Although some businessmen want to have a virtual angiography every year, this is not true.
Who cannot have virtual angiography?
• Kidney function disorders,
• Hyperthyroidism,
• Virtual angiography cannot be applied to people with heart rhythm disorders.
Is virtual angiography a frequently used method?
Virtual angiography is an examination method frequently used in appropriate patient groups at Anadolu Health Center. This examination is used not only for coronary angiography but also to evaluate all vascular structures of the body.
In which areas does virtual angiography work best?
The areas where virtual angiography gives the best results are structural heart and vascular disorders. It also provides near-perfect results in the evaluation of the added vessels of patients who have undergone bypass. Excluding coronary artery disease is one of the areas where the examination is most successful; However, it can sometimes evaluate coronary artery stenosis as more serious than it actually is.
How much time should pass between two virtual angios?
It is not very convenient to give a time for this; However, there must be a serious reason that requires repeating the patient’s virtual angiography. It is not appropriate to use this examination for check-up purposes.
Can virtual angiography be applied to children?
It is generally applied for structural heart defects and vascular disorders in children. Sometimes it can give better results than classical angiography.
What are the misconceptions about virtual angiography?
Virtual angiography is not a screening test. The most appropriate use of this test is to show that patients at low risk of having coronary artery disease do not have this disease.
Can you give information about the accuracy rates of the results?
The strongest point of virtual angiography is that it shows that the person does not have coronary artery disease. In the presence of disease, it can correctly identify the disease at a rate of 80-90 percent. In structural cardiovascular diseases, accuracy rates in evaluating the patency of vessels added after bypass have been found to be close to 100 percent.
