Nowadays, we mostly perform coronary angiography for patients with suspected coronary artery disease. Since this test is an invasive procedure, some patients may have questions and concerns about the risks involved. Is it possible not to do it? So today I will talk about the issue of “why do you need to do the angiography”.
1.What is coronary angiography
Coronary angiography technology is the use of angiography machine, through the special-shaped cardiac catheter percutaneous puncture into the right radial artery or lower limb femoral artery, to the root of the ascending aorta, and then inserted into the left or right coronary artery mouth, injecting contrast, so that the coronary artery image. In this way, the entire trunk of the left or right coronary artery and the lumen of its branches can be clearly shown, and it is possible to understand the presence or absence of stenotic lesions, to make a clear diagnosis of the lesion site, scope, severity and condition of the vessel wall, to decide the treatment plan (intervention, surgery or medical treatment), and also to judge the efficacy of treatment.
2.Is there any risk in doing coronary angiography?
Coronary angiography is performed under local anesthesia, and there are no sensory nerves in the blood vessels and heart, so the patient only feels slight pain during local anesthesia, but no significant discomfort during the rest of the procedure. There is a risk of complications with any procedure, so patients are required to sign a formality before the procedure. The complication rate of coronary angiography is 0.2%~0.9%, mainly arrhythmia, local bleeding from the puncture, hematoma, pseudoaneurysm and arteriovenous fistula. Most of the above-mentioned complications do not constitute serious consequences, and the incidence of complications is extremely low in skilled operators. In conclusion, coronary angiography is a very low risk, relatively safe and almost painless procedure.
3.Advantages of coronary angiography
Coronary angiography is widely used in clinical practice and is considered the “gold standard” for the diagnosis of coronary artery disease. It not only helps to confirm the diagnosis, but also is an important basis for deciding which treatment the patient should receive. The basic plan of interventional treatment, coronary artery bypass surgery and drug treatment are all based on the imaging results. Although intracoronary ultrasound imaging (IVUS) and optical interferometric tomography (OCT) have been gradually applied in clinical practice in recent years, and it has been found that intimal thickening or plaque exists in some segments of the vessels that are normal in coronary angiography, IVUS and other tests are not routine now because they are more expensive and more complicated to operate.
4.Indications for coronary angiography
1)unexplained chest pain, arrhythmia or left heart insufficiency that cannot be confirmed by non-invasive examination.
2)Recurrent angina after interventional therapy (PCI) or coronary artery bypass grafting (CABG).
3) before major surgery such as congenital heart disease and valvular disease.
4) Asymptomatic but suspected coronary artery disease in high-risk occupations such as: pilots, automobile drivers, police officers, athletes and firefighters, or as required by medical insurance.
In general, in clinical practice, if the stenosis and other conditions are shown during the angiography can be directly treated with PCI.
5. Contraindications of coronary angiography
1) Allergy to iodine or contrast media.
2)Those who have severe cardiopulmonary insufficiency and cannot tolerate the procedure.
3)Uncontrolled severe arrhythmias such as ventricular arrhythmias.
4)electrolyte disturbances.
5) severe liver and kidney insufficiency.
Now you should have a more comprehensive understanding of coronary angiography and be able to understand why it is widely used in clinical practice. It not only helps us to make a clear diagnosis, but also helps us to choose the appropriate treatment plan, and with skilled operation and proper care, it can be said that the risk is minimal. Therefore, I hope that you will not be too worried about the contrast examination and must go to a regular institution for examination and treatment.