Frequently Asked Questions About Angiography
Frequently Asked Questions About Coronary Angiography
Cardiovascular disease continues to be the leading cause of death worldwide and in Turkey. In fact, it causes the deaths of 200,000 people annually in Turkey. Therefore, early diagnosis in cardiovascular disease is vital. Coronary angiography, referred to colloquially as 'angio' and used to determine whether there is narrowing in blood vessels, continues to hold its place as the 'gold standard' among diagnostic methods. This is because it allows direct visualization of blood vessels and enables intervention for treatment in the same session if needed. Assoc. Prof. Murat Turfan, Cardiologist at Acibadem Taksim Hospital, points out that coronary angiography is a life-saving diagnostic method, stating: "Moreover, thanks to techniques developed to date, procedures can be performed painlessly. Images of blood vessels can be obtained in minutes, or even seconds. Patients may also have the chance to return to their normal lives the same day." Assoc. Prof. Cardiologist Murat Turfan answered 8 of the most frequently asked questions about coronary angiography and provided important information!What Is Coronary Angiography?
Coronary angiography, one of the most frequently performed cardiological examinations, is the process of visualizing the coronary arteries that supply the heart. Life-threatening vessel obstructions are detected through this method. Narrowed or obstructed vessels can be opened with a balloon or stent during the angiography procedure. This eliminates the patient's complaints, improves quality of life, and extends lifespan.In Which Conditions Is It Used?
If results from diagnostic methods such as ECG, echocardiography, and stress testing indicate possible vessel obstruction, coronary angiography is performed. The angiography definitively determines whether vessel obstruction is present.Why Is Coronary Angiography Important?
Assoc. Prof. Cardiologist Murat Turfan notes that coronary angiography performed during a heart attack and subsequent stent placement are life-saving, stating: "The sooner vessel patency is restored, the greater the patient's chance of survival. Studies have shown that stent treatment applied after angiography can extend lifespan not only in heart attacks but also in certain special conditions such as extensive vessel disease or lesions at the beginning of the main artery."How Many Types of Angiography Exist?
Currently, three types of angiography are used: classical, computed tomography, and MR angiography. The choice of angiography method depends on the patient's age, clinical presentation, risk factors, and comorbidities. Assoc. Prof. Cardiologist Murat Turfan emphasizes that computed tomography (CT) coronary angiography, commonly known among the public as 'bloodless angio' or 'virtual angio,' is preferred in low-risk patients, stating: "Because it is not an invasive method, carries lower risk compared to classical angiography, and provides nearly as clear information as classical angiography in selected patients, the number of angiographies performed with computed tomography is increasing steadily." Assoc. Prof. Murat Turfan provides information that "MR method is a technique that provides us with clear information about the heart's functions and structure, and is the gold standard in some cases. When we want to examine both cardiac function and coronary vessels, cardiac MR and MR angiography are the preferred methods."How Is Coronary Angiography Performed?
Classical angiography: Coronary angiography, performed in a special laboratory setting and usually under local anesthesia, involves accessing the blood vessels from the wrist or groin, after which a thin plastic catheter is used to reach the heart's blood vessels. A special contrast agent is then injected into the vessels to make them visible. Blood vessels are imaged from different angles to determine whether obstruction is present. Patients are discharged after a maximum of 6 hours if angiography is performed from the groin, a maximum of 3 hours if performed from the wrist, and one night later if a stent or balloon is used. However, if an unusual situation occurs related to the procedure, this period may be extended. Assoc. Prof. Cardiologist Murat Turfan points out that wrist angiography has become more frequently performed in recent years, stating: "The reason is lower complication risk, a more comfortable procedure, and less impact on the patient's normal activities after the procedure." Coronary CT angiography: Coronary (computed tomography) angiography is a tomography that visualizes the blood vessels supplying the heart. In this method, powerful X-rays are used to provide images of the heart and blood vessels. First, a vascular access is placed in the hand or arm. The patient is asked to lie inside the CT machine. The blood vessels are then imaged in a short period of about 5 seconds. The completion of all procedures takes somewhat longer.What Precautions Should Be Taken After the Procedure?
On the day classical coronary angiography is performed, it is necessary to drink plenty of water and rest to help the body eliminate the contrast agent. It is particularly important not to drive for 24 hours, especially for patients who had access from the groin. In angiographies performed from the groin, after the sheath is removed, pressure with a sand bag is applied for 6 hours, during which the leg should not be moved. In procedures performed from the wrist, heavy lifting and exercise should be avoided for 2 days. In CT angiography, since no different procedure is performed than any other CT examination, the patient can return to normal life immediately after the examination; drinking plenty of water is sufficient.Is Coronary Angiography a Risky Method?
As with most procedures performed on the heart and blood vessels, coronary angiography involves exposure to radiation from X-rays. However, serious complications develop rarely in all angiography methods.Which Method Can Be Applied to Which Patient?
Classical coronary angiography is a method that can be applied to every patient. CT coronary angiography is completed in a shorter time compared to classical angiography. Additionally, it is not invasive, only vascular access is required, and the complication risk is relatively lower. "However, these advantages do not mean the method can be applied to everyone," warns Assoc. Prof. Murat Turfan, continuing: "In patients with known coronary artery disease, especially those who have undergone stent treatment, this method is not used except in special cases. The appropriate patient group consists of those who are not high-risk for coronary artery disease, are not morbidly obese, and have no conditions such as arrhythmia that would impair imaging quality. We prefer the CT angiography method mainly in patients who are at low risk."Advertisement
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