PROCEDURES
Coronary angiography and coronary interventions
Overview
Coronary angiography is a diagnostic assessment that uses x-ray imaging to see inside the heart’s blood vessels.
Why it’s performed
Coronary angiography is a test done to assess blood flow to the heart. Catheterisation is a form of intervention to intersect and diagnose heart disease. First, a special dye is used to highlight the heart's blood vessels. Then an x-ray machine captures images of the blood vessels, indicating any issues present.
An angioplasty is required when one of the heart's blood vessels becomes obstructed. Dr Abelson has to open up the clogged arteries using a surgical balloon or stent in this particular situation.
Coronary angiography and angioplasty are needed in case you develop coronary artery disease symptoms like chest pain and unstable angina or other signs of an underlying condition such as pain in the arm, neck or chest.
An angiography will help diagnose unstable and persistent chest pain. In addition, this forms part of a second test when the results of an ECG are abnormal. In some cases, a defect of the heart valve is a problem, in which case, an angioplasty is required.
Preparation
An angiogram is typically performed in the Cath lab of the doctor’s practice. We review medications and supplements taken beforehand as well as any allergies present. Afterwards, we carry out a physical examination to check vital signs, including the patient's blood pressure.
Procedure
A bendable plastic tube (sheath) is inserted through an incision in the groin or arm. A catheter is then inserted through the sheath and threaded through the heart’s coronary arteries. Next, dye is injected into the catheter. This is an integral part of the process as the dye travels through the blood vessels, indicating blood flow and any obstructions affecting the flow. Depending on the outcome of the procedure, a stent may be inserted, or a balloon angioplasty may be performed if there is a blockage in one of the vessels.
Another option is rotational atherectomy, a coronary intervention to remove thick plaque from the heart's blood vessel. By surgically removing plaque, the inside of the artery widens, allowing blood to travel freely. Dr Abelson uses rotary blades or a laser at the catheter's tip to remove plaque for this particular procedure. The type of procedure he chooses differs in each case, depending on your condition and eligibility.
Intra-coronary imaging (intravascular ultrasound and OCT, an optical coherence tomography) has made it possible to perform angioplasty with remarkable skill. In addition, these imaging studies and functional assessments evaluate the heart's performance which is vital for your overall health.
Recovery
As soon as the angiography is complete, Dr Abelson removes the catheter and closes the incision using a plug manually. You may need to rest for a few hours, particularly if the catheter was placed through an incision in the groin. By applying pressure after the procedure, we prevent excessive bleeding from the groin. Usually, this is a minor day procedure, so you can ask someone to drive you home afterwards.
