Cardiovascular diseases continue to be the leading cause of death all over the world and in our country. So much so that it causes the death of 200 thousand people every year in Turkey. Therefore, early diagnosis of cardiovascular diseases is of vital importance. ‘Coronary angiography’, which is popularly referred to as ‘angio’ and used to detect whether there is stenosis in the vessels, continues to maintain its place as the ‘end point’ in diagnostic methods. The reason for this is that it allows direct visualization of the vessels and, if necessary, intervention for treatment in the same session. Acıbadem Taksim Hospital Cardiology Specialist Assoc. Dr. Murat Turfan pointed out that coronary angiography is a life-saving diagnostic method and said, “Moreover, thanks to the techniques developed to date, the procedures can be performed painlessly and without pain. The images of the veins can be taken in minutes or even seconds. “Patients also have the chance to return to their normal lives on the same day.” Cardiology Specialist Assoc. Dr. Murat Turfan answered the 8 most frequently asked questions about coronary angiography; Gave important information!
WHAT IS CORONARY ANGIOGRAPHY?
Coronary angiography, one of the most frequently performed cardiological examinations; It is the process of imaging the coronary vessels that feed the heart. Vascular occlusions that threaten our life are detected by this method. The vessels that are determined to be narrowed or occluded can be opened with a balloon or stent during angiography. In this way, the patient’s complaints disappear, their quality of life increases and their lifespan is extended.
WHICH PROBLEMS ARE APPLIED?
If the results of diagnostic methods such as ECG, ECO and exercise test indicate a possible vascular occlusion, coronary angiography is performed. As a result of the procedure, the presence of vascular occlusion is definitively determined by angiography.
WHY IS CORONARY ANGIOGRAPHY IMPORTANT?
Cardiology Specialist Assoc. Dr. Murat Turfan stated that coronary angiography performed during a heart attack and the stent applied afterward are life-saving and said, “The sooner vascular patency is established, the higher the patient’s chance of survival. In the studies carried out; It has been shown that stent treatment applied after angiography can prolong life in some special cases, such as diffuse vascular disease or the presence of lesions at the beginning of the main vessel, except for heart attack.
HOW MANY TYPES OF ANGIOGRAPHY ARE AVAILABLE?
Today; Three types of angiography are used: classical, tomography and MR angiography. Which angiography method will be applied is decided according to the patient’s age, clinic, risk and co-factors. Cardiology Specialist Assoc. Dr. Murat Turfan emphasized that the computed tomography (CT) coronary angiography method, known as ‘bloodless angiography’ or ‘virtual angiography’, is preferred in low-risk patients, and said: Today, the number of angiography performed with computed tomography is increasing day by day, as it provides almost as clear information as classical angiography.” Assoc. Dr. Murat Turfan said, “MR method is a method that gives us clear information about the functions and structure of the heart and is the gold standard in some cases. Cardiac MRI and MR angiography are the preferred methods when we want to examine both cardiac functions and cardiovascular systems.
HOW IS CORONARY ANGIOGRAPHY APPLIED?
Classical angiography: In coronary angiography, which is performed in a special laboratory environment and usually under local anesthesia, the heart vessels are reached with a thin plastic cable after the vascular access is opened from the wrist or groin. Then a special drug called ‘contrast agent’ is injected into the veins to make them visible. The veins are viewed from different angles to determine whether there is a blockage. The patient is discharged after a maximum of 6 hours in groin angiography, a maximum of 3 hours in wrist procedures, and after one night when stent or balloon is applied. However, if there is an unusual situation regarding the transaction, this period may be extended. Cardiology Specialist Assoc. Dr. Murat Turfan, drawing attention to the fact that wrist angiography has started to be applied more in recent years, says, “The reason for this is that there is less risk of complications, a more comfortable procedure and less impact on the patient’s normal life after the procedure.”
Coronary CT angiography: Coronary (computed tomography) angiography; It is a tomography that displays the vessels that supply blood to our heart. This method uses a powerful x-ray 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 down inside the CT device. Veins are then displayed in as little as 5 seconds. All processes take a little longer to complete.
WHAT SHOULD BE CONSIDERED AFTER THE PROCEDURE?
On the day of classical coronary angiography, it is necessary to drink plenty of water and rest in order to remove the contrast agent from the body. It is important not to drive 24 hours a day, especially for patients who use the groin area. In groin angiomas, pressure is applied with a sandbag for 6 hours after the sheath in the groin is removed, and the leg is not asked to move during this time. In operations performed on the wrist, heavy lifting and sports should not be done for 2 days. Since CT angiography is not different from any tomography examination, it is sufficient for the patient, who can return to normal life immediately after the examination, to drink plenty of water.
IS CORONARY ANGIOGRAPHY A RISKY METHOD?
As with most procedures on the heart and blood vessels, coronary angiography involves radiation from X-rays. However, serious complications develop in very rare cases in all angiography methods.
WHICH METHOD CAN BE APPLIED TO WHICH PATIENTS?
Classical coronary angiography is a method that can be applied to every patient. CT coronary angiography method is completed faster than classical angiography. In addition, it is not invasive, only vascular access is sufficient and the risk of complications is relatively low. “However, these advantages do not mean that the method can be applied to everyone,” warned Assoc. Dr. Murat Turfan continues: “Except in special cases, this method is not used in patients with known coronary artery disease, especially in patients with stent treatment. Suitable patient group; They are people who are not at high risk for coronary artery disease, who are morbidly obese and who do not have a condition that would hinder the quality of shooting, such as arrhythmia. We prefer the CT angiography method mostly in patients with low risk.”