Angiogram & Angioplasty

Angiogram & Angioplasty

Coronary Angiography

Coronary Angiography

This is a procedure by which a contrast material is injected directly into the blood vessel (coronary arteries) and is seen by a specialized X-ray machine which takes picture in real time motion. A small tube is inserted through the groin (femoral artery) or through the hand (radial or ulnar artery) which goes up to the origin of coronary arteries and then the contrast material is injected directly into these arteries.

It is a relatively painless procedure which takes 15-20 minutes to complete and the patient can go home in one hour if done through the hand or in 4-5 hours if done through the groin. With the availability of newer generation contrast agents the chance of developing any serious complication is almost negligible (less than 0.001%). Angiography can tell us how many coronary arteries are blocked and outline the site and degree of block, which helps in planning the further course of treatment like medical management if blockages are less than 50% or angioplasty or bypass surgery if block is more than 50-70%.

Balloon Angioplasty and Stenting

This is a procedure used to restore the blood flow through a blocked artery. Dilating the blockage with balloon is called Balloon Angioplasty and deploying a stent is called Stenting. A tiny plastic tube (guiding catheter) is passed through the groin or hand till the origin of coronary arteries, and then a thin soft wire (guide wire) is passed through this tube and is negotiated across the block. Then another tube having a balloon at one end is passed over this wire up to the site of blockage. At this point the balloon is inflated to widen the artery by pushing the plaque against the wall of the artery thereby restoring the blood flow. This technique was first used in 1977 by Andreas Gruentzig and from that day it has evolved dramatically to its current status. Now-a-days after dilating with the balloon, a stent is deployed to keep the artery open.

A stent is a tiny metallic mesh tube looking like a spring. We have two types of stents i.e. drug eluting and bare metal. The advantage of the drug eluting stent is that they have been able to achieve a very low reblockage rate of about 0-5% which used to be about 25-30% with bare metal stents.

The stent remains in the body throughout life. The only problem is development of reblockage at the same place where the stent is deployed and this can be minimized by the use of drug eluting stents. Stents cannot be removed after deployment. After 1 to 3 months the endhothelial layer forms over the stent and then they become a part of our body.