What is Angiography?

Angiography is carried out to visualize the lumen of the blood vessels for
detecting blockages. It confirms the presence of blockages and their severity in
the arteries that supply the heart muscle. Based on the results, the Cardiologist
decides on further treatment medicines, angioplasty or bypass surgery.
What is Coronary Angioplasty?
Coronary Angioplasty (often called Percutaneous Transluminal Coronary Angioplasty
or PTCA) is a method of improving blood flow through a narrowed artery with the
help of mechanical devices like balloons and stents.
A Coronary Angiography is indicated when ...
The patient has "typicar angina chest pain. The patient has positive stress test
result. For patients with Acute heart attack [MI]
Angioplasty is indicated when :
The angiography performed indicates significant blockages in any of the 3 blood
vessels supplying the heart, indicating Coronary Artery Disease If medical
treatment is not likely relieve angina totally. This is done to relieve the patient of
his symptoms like chest pain and breathlessness.
What are the investigations carried out before the procedure?
ECG, 2D- ECHO, Complete blood count, fasting blood sugar, TSH, Sr. Creatinine, HIV,
HbsAg & HCV.
What are the investigations carried out before the procedure?
ECG, 2D- ECHO, Complete blood count, fasting blood sugar, TSH, Sr. Creatinine, HIV,
HbsAg & HCV.
Do all patient undergoing angiography require an angioplasty or a bypass surgery?
No not at all. Based on the findings of the angiography [i.e. the number &
percentage of blockages] the Cardiologist determines the further course of action of
either an angioplasty or a bypass. Only about one third patients undergoing
angiography would eventually require either of the above procedures.
If the angioplasty is done via the radial route [wrist] then : Dressing on the
puncture site will be changed, if required. Movement of the hand of procedure
should be restricted for at least 12 hours.
If the angioplasty is done via femoral route [groin area] then :

 The sheath will be removed after 6-8 hours and pressure given on the puncture
site to stop any bleeding. Movement of the leg with the puncture site should be
restricted for 6 hrs. If you get a moist sensation at the punctured site, please CALL
THE NURSE IMMEDIATELY. In case of chest pain or shortness of breath, please
intimate the nurse.
How is the procedure performed?
The procedure is carried out by introducing a catheter through the arteries of the
leg or arm. This catheter is then positioned near the opening of the coronary
arteries. A dye is then injected to take pictures of the arteries Mild sedation and
local anesthesia is administered.
The actual procedure :
A small tube [sheath] is inserted into the wrist or groin and a guiding catheter is
inserted through this sheath into your coronary artery. Contrast dye is injected
through the catheter to see your coronary arteries on an X-ray machine with a LCD
screen. As soon as the coronary arteries and the blockages come into view, an
ultrathin guide wire is used to cross the blockage. By watching the progress of this
wire on the x-ray N screen [fluoroscope], the doctor is able to maneuver it into the
blocked coronary artery. Once it is positioned across the blockage, the balloon is
passed over the wire and inflated compressing the fatty deposits against the wall of
the blood vessel. In this way, the diameter of the lumen of the blood vessel is
increased. The balloon is then deflated and withdrawn. Later a balloon carrying
the stent is placed across the blockage and inflated. The stent stays in place
permanently, holding the blood vessel open, improving the flow of blood and
relieving the symptoms of the coronary artery disease.
What are the complications of both the procedures?
It is a very safe procedure. However, being an invasive procedure it has a
mortality risk of 0.1%. The risk is higher for patients with heart failure,
arrhythmias, severe angina and in children with severe cyanosis.
Author Bio
P. D. Hinduja Hospital is a leading multispecialty hospital, considered as the best
hospital in Mumbai, India. It is an ultra-modern tertiary care hospital, Internationally
acclaimed for its world class medical services.
In December 2014 it was Awarded as the "Best Multi-Specialty Hospital in Mumbai"