Angiography is not a treatment, but a diagnostic method

Angiography, which is still considered the gold standard for imaging the heart's blood vessels, plays a very important role in the diagnosis and treatment of cardiovascular diseases. Anadolu Health Center cardiology specialists emphasize that angiography is a diagnostic method aimed at revealing the narrowing or blockage of coronary vessels to determine the treatment approach. They answer questions you may have regarding angiography…

What is coronary angiography?

It is an imaging method that shows how blood flows in any vascular system and whether there are issues such as narrowing or blockage. Angiography can be performed on all blood vessels in the body. The angiography performed to examine the heart vessels is referred to as coronary angiography. Through coronary angiography, it is determined which part of the coronary arteries is narrowed or blocked due to arterial stiffness.

Is angiography a treatment or an imaging method?

Yes, coronary angiography is essentially an imaging method that helps shape the treatment approach.

Who can undergo angiography, and who cannot?

Coronary angiography is performed on all patients suspected of having narrowing or blockage in their heart vessels. For example, those with chest pain and positive exercise tests, as well as individuals who have experienced a heart attack.

Is the decision for angiography made immediately?

It is planned to perform angiography immediately on all patients suspected of having narrowing in their heart vessels.

Can there be an allergy to the substance used?

In angiography, we use an opaque substance that contains iodine. Therefore, there is a risk of allergy for those who are allergic to iodine.

Is hospitalization required for the angiography procedure? How long is the required stay?

For the angiography procedure, a same-day admission is sufficient.

What tests need to be done before angiography?

Before the procedure, it is important to conduct a complete blood count and determine the urea and creatinine levels. There is also a risk of bleeding and potential impairment of kidney function due to the contrast material used. Patients with kidney insufficiency, in particular, constitute a high-risk group. Therefore, these patients are monitored more closely.

Can food be consumed before angiography?

Fasting for 3-4 hours prior to the procedure is required.

What should be done if there are regular medications?

Patients can continue to take their medications. However, anticoagulant medications should be discontinued as they increase the risk of complications.

Which doctor performs the angiography procedure?

The procedure is performed by cardiologists.

How is angiography performed?

In this procedure, a small skin incision is made in the groin area, and a needle is inserted into the groin vein. A guide wire is placed into the vessel, and plastic sheaths of 15-20 cm in length are placed over this wire to facilitate the movement of catheters, providing access to the vascular system. In coronary angiography, a contrast agent is administered into the coronary arteries that supply the heart, making these vessels visible through very thin plastic tubes called catheters. The images obtained during this procedure are recorded on film.

Is anesthesia used during angiography?

The patient undergoing angiography does not need to be under general anesthesia. The skin area where the procedure will be performed is numbed with local anesthesia. If necessary, devices such as balloons and stents are used to alleviate coronary narrowing, similarly conducted through catheters as in angiography.

How long does the angiography procedure take?

The procedure lasts approximately 10-15 minutes. After the procedure, the tube inside the artery is removed, and pressure is applied for a while to prevent bleeding. Once it is confirmed that there is no bleeding, a tight dressing is applied. If the procedure was performed through the groin, the patient will be advised to rest in bed for 5-6 hours; if it was done through the arm, the patient will be observed for 1-2 hours before being discharged home.

Do patients feel pain during the angiography procedure?

Generally, a sedative medication is administered before entering the catheter laboratory to help the patients relax. Most people do not feel pain during the procedure. However, some patients may express that they feel a slight discomfort. Similar to a tooth extraction, the area where the procedure is performed is numbed with a local anesthetic (which causes loss of sensation), and the discomfort felt is comparable to that of a needle prick.

Do patients feel pain after the angiography?

After the procedure is completed, the catheter is removed. After the catheter is withdrawn, tight pressure is applied to the groin area of the artery where the intervention was performed to prevent bleeding. This pressure may cause some discomfort. Additionally, to prevent further bleeding, sandbags may be placed on the groin area, and the patient is asked to lie on their back.

What complications can a patient encounter after angiography?

Problems that may arise related to the procedure are mainly concerning the site of entry into the vessel. For example, in cases of leg artery blockages, the groin artery may be plaque-filled, narrowed, or completely obstructed, making it impossible to access the artery and advance the catheters. In obese patients, due to the artery being very deep and underneath a layer of fat, it may be difficult to access the artery, and problems may arise in stopping bleeding after the procedure. Bleeding can sometimes occur under the skin, leading to bruising that may extend down to the knee. The frequency of these complications ranges from 2% to 8%.

Do angiography results provide enough clues regarding heart diseases?

Angiography shows whether there is narrowing in the coronary vessels. It also provides information about the contraction function of the left ventricle of the heart. However, it does not give sufficient information about other heart diseases.

How long after angiography can surgery be performed?

This depends on the severity and type of the disease. For example, patients who experience chest pain despite medication during rest should undergo emergency surgery.

If a second angiography is necessary, how much time should pass between the two angiographies?

If needed, the second angiography can be performed immediately.

Complications that may arise from angiography

• Bleeding related to the vessel where the intervention was performed, blockage of the vessel, or the formation of a path called a fistula between the vein and the artery. Sometimes surgery may be necessary for these vessels.
• Allergy to the contrast material used in the procedure.
• Kidney insufficiency due to the contrast material.
• Perforation or tearing along the artery where angiography is performed.
• Rupture of the coronary artery.
• Heart attack.
• Fatal arrhythmia (ventricular fibrillation).
• Thrombosis of brain vessels due to embolism from vessels along the angiography catheter or air entering during drug administration to the vascular system, leading to stroke.