Angiography is a diagnostic method, not a treatment.
Angiography, which is still considered the gold standard in imaging cardiovascular vessels, has a very important place in the diagnosis and treatment of cardiovascular diseases. Anadolu Health Center Cardiology Specialists say that angiography, which is performed to reveal the narrowing or occlusion in the coronary vessels and determine the treatment method, is not a treatment but a diagnostic method, and answers the questions you want to know about angiography…
What is coronary angiography?
It is an imaging method that shows how blood flow is in any vascular system and whether there are problems such as stenosis or obstruction. Angiography can be performed for all vessels in the body. Angiography performed to examine the heart vessels is called coronary angiography. With coronary angiography, it is determined which area of the coronary arteries is narrowed or blocked due to arteriosclerosis.
Is angiography an imaging method, not a treatment?
Yes, coronary angiography is actually an imaging method that helps shape the treatment.
Who can undergo angiography and who cannot?
Coronary angiography is performed on all patients who are thought to have narrowing or occlusion in the heart vessels. For example, those with chest pain, those with a positive stress test, and those who had a heart attack.
Is the angiography decision taken immediately?
Immediate angiography is planned for all patients who are thought to have stenosis in the heart vessels.
Is it possible to have an allergy to the substance used?
We use opaque material in angiography. This is a substance containing iodine. Therefore, there is a risk of allergy in those who are allergic to iodine.
Do I need to stay in the hospital for an angiography? How long should I stay in bed?
A day hospital stay is sufficient for angiography.
What tests need to be done before angiography?
It is important to determine blood count and urea-creatinine values before the procedure. There is also a risk of bleeding and the opaque material impairing kidney functions. Especially patients with kidney failure constitute the risk group. Therefore, these patients are controlled more tightly.
Can I eat before angiography?
3-4 hours of fasting is required before the procedure.
What should be done if there are medications used regularly?
Patients can continue to use their medications. Only blood thinners should be discontinued because they increase the risk of complications.
Which doctor performs angiography?
Cardiologists perform the procedure.
How is angiography performed?
In this procedure, a small skin incision is made in the groin area, a needle is entered into the groin vein, a guide wire is placed into the vein, and 15-20 cm plastic sheaths that allow the catheters to move easily are placed over this wire, providing access to the vascular system. In coronary angiography, contrast material is injected into the coronary vessels feeding the heart through very thin plastic tubes called catheters, making these vessels visible. With this process, which allows the veins to be visualized, the images obtained at the same time are recorded on film.
Is anesthesia used in angiography?
The patient who will undergo angiography does not need to be under general anesthesia. The skin area to be treated is anesthetized with local anesthesia. When necessary, the removal of coronary stenosis by using therapeutic devices such as balloons and stents is also done similarly through catheters such as angiography.
How long does it take to complete the angiography?
The process takes approximately 10-15 minutes. After the procedure, the tube in the artery is removed and pressure is applied for a while to prevent bleeding. Once you are sure that the bleeding has stopped, a tight dressing is applied. If the procedure was performed in the groin, the patient is discharged home after 5-6 hours of bed rest, and if the procedure was performed in the arm, after 1-2 hours of observation.
Does the patient feel pain during the angiography procedure?
Usually, a sedating medication that helps patients relax is given before entering the cath laboratory. Most people do not feel pain during the procedure. Some patients state that it hurts slightly. Just like in tooth extraction, the area where the procedure will be performed is anesthetized with a local anesthetic (providing loss of sensation). During this time, pain is felt as much as a needle prick.
Does the patient feel pain after angiography?
After the procedure is completed, the catheter is removed. After the catheter is removed, firm pressure must be applied to the groin area to prevent bleeding from the artery being attempted. Pain may be experienced due to pressure. Additionally, to prevent rebleeding, sandbags are placed in the groin area and the patient is asked to lie on his back.
What can the patient encounter after angiography?
Problems that may occur during the procedure are mostly related to the vascular entry site. For example, as in leg vein occlusions, the groin vein may be plaque-filled, narrowed, or completely blocked, making it impossible to enter this vein and advance catheters. In obese patients, since the vein is very deep and under the fat mass, it is difficult to enter the vein and problems may occur in stopping bleeding after the procedure. Bleeding sometimes occurs under the skin. This can cause blood accumulation and bruising in the entire leg down to the knee. The incidence of these complications is between 2 and 8 percent.
Do angiography results give enough clues about heart diseases?
Angiography shows whether there is stenosis in the heart vessels. It also gives information about the contractile function of the left ventricle of the heart. However, it does not provide sufficient information about other heart diseases.
How soon after angiography can surgery be performed?
This depends on the degree and form of the disease. For example, patients who have chest pain despite medication at rest should undergo emergency surgery.
If a second angiography is required, how much time should pass between two angiograms?
If necessary, a second angiography can be performed immediately.
Complications that angiography may cause
• Bleeding related to the operated vessel, occlusion of the vessel, formation of a path called fistula between the vein and artery. Sometimes surgery may be necessary for these veins.
• Allergy to the opaque material used in the procedure
• Renal failure due to opaque substance
• Puncture, tear along the angiographed vessel
• Rupture of the heart vessel
• Heart attack
• Fatal arrhythmia (ventricular fibrillation)
• Occlusion of brain vessels and stroke due to clot removal from the vessels in the angio catheter path or air leakage during drug administration to the vascular system.
