Chest pain, shortness of breath, or risky ECG findings may require evaluation of the heart’s vessels. Angiography is one of the clearest and fastest ways of this evaluation process. This procedure, which can be applied for both diagnostic and therapeutic purposes, often paves the way for interventions such as stent placement.
- What Is Angiography? What Purpose Is It Performed For?
- Who Is Angiography Applied To and When?
- What Is the Difference Between Stent Placement and Angiography?
- How Should Pre-Angiography Preparation Be?
- How Is Angiography Performed?
- Differences Between Wrist Angiography and Groin Angiography
- What Do You Feel During Angiography?
- What Is the Process After Angiography? What Should Be Considered?
- What Are the Risks and Side Effects of Angiography?
- How Are Angiography Results Evaluated?
- When Should You Consult a Doctor?
- Frequently Asked Questions
What Is Angiography? What Purpose Is It Performed For?
Coronary angiography is a procedure performed to directly visualize the vessels that supply the heart (coronary arteries). This method clearly reveals whether there is vessel blockage, narrowing, or abnormal structure. It can be performed for diagnostic purposes, and in some cases, treatment (stent) can also be applied in the same session. Thanks to angiography, heart attack risk can be determined and the source of existing complaints can be clarified.
During the procedure, a catheter is inserted through the groin or wrist vessel and contrast material is given to the heart vessels. This material allows the vessels to be seen on the X-ray device. Blocked or narrowed areas are detected with millimeter precision. This information plays a role in determining the patient’s treatment plan.
Who Is Angiography Applied To and When?
Angiography serves as an evaluation and decision tool for patients who carry serious problem risks in their heart vessels. If your symptoms are considered risky or if the tests performed suggest vessel blockage, the physician may recommend this procedure. Sudden onset chest pain, exertional shortness of breath, and suspected heart attack are among the main reasons for this procedure. It is also applied in a planned manner in some patients.
Re-evaluation may be needed in those who have previously had a heart attack, or in people who have had stents or bypass surgery. Angiography decisions can also be made in patients whose stress test, scintigraphy, or echocardiography results are risky. This procedure is also diagnostic in patients with complaints whose cause cannot be explained.
What Is the Difference Between Stent Placement and Angiography?
Angiography is used to visualize heart vessels, while stenting is used to open blocked vessels. Angiography is a diagnostic method; if a problem is detected, treatment can be started in the same session. Stent placement allows the narrowed or blocked vessel to be reopened with a special metal cage. Not every angiography requires a stent; stenting is only applied if the narrowing is found to be serious.
How Should Pre-Angiography Preparation Be?
Pre-angiography preparation is of great importance for the procedure to be safe and give clear results. Fasting time, medication adjustment, and completion of some tests are required. It is important for patients using medications to act according to physician recommendations, especially regarding blood thinners. Comfortable clothes should be worn on the procedure day, and support should be taken after vascular access is obtained if necessary.
Generally, it is necessary to fast for 6-8 hours before the procedure. Diabetic patients should adjust their insulin or medication use by consulting their physician. Special precautions are taken to reduce risks related to contrast material for those with kidney disease. Blood tests, ECG, and sometimes chest X-ray may be requested beforehand.
How Is Angiography Performed?
Angiography is performed in a catheter laboratory under sterile conditions with X-ray devices. The heart vessels are reached by entering through the wrist (radial artery) or groin (femoral artery) vessel. Contrast material is given with the help of a thin and flexible catheter, and the vessels are imaged. The procedure usually takes 15-30 minutes.
The patient remains awake throughout the procedure, only relaxation is provided with a sedative given through the vessel. The blockage status of heart vessels is evaluated with the help of images. If there is serious narrowing, balloon dilation or stent placement is possible in the same session. The heart’s electrical activity and blood pressure are continuously monitored at every stage.
Differences Between Wrist Angiography and Groin Angiography
Wrist angiography (radial approach) is performed through the artery located in the wrist. The bleeding risk is lower, and the patient can get up faster after the procedure. It is frequently preferred today.
Groin angiography (femoral approach) is performed through the large artery in the groin area. It is especially preferred in some anatomical situations or emergency cases. However, longer bed rest may be required after the procedure.
What Do You Feel During Angiography?
Patients usually do not feel serious pain or discomfort during angiography. Advancing the catheter does not cause pain; there may only be a brief feeling of warmth or pressure. When contrast material is given, mild warming in the chest and a wave of warmth spreading throughout the body may be felt. This condition is normal and passes within a few seconds.
You can talk during the procedure and ask questions if you wish. Rarely, temporary side effects such as dizziness or nausea may develop. When you feel serious discomfort, your team intervenes immediately. You are expected to recover quickly after angiography.
What Is the Process After Angiography? What Should Be Considered?
A careful follow-up process is required after angiography. Bleeding, swelling, or bruising may develop depending on the area where the catheter entered (wrist or groin). Therefore, pressure should be applied to the area, and the rest period should be planned according to physician recommendation. You will be kept under observation in the hospital for a few hours after the procedure.
After returning home, you should not lift heavy objects for the first 24 hours, consume plenty of fluids, and keep the catheter entry site dry. If blood thinning medications are to be restarted, your physician will give detailed information. If symptoms such as pain, redness, or bleeding develop, you should immediately apply to a healthcare institution.
What Are the Risks and Side Effects of Angiography?
Angiography is generally a safe procedure, but like any medical intervention, it has some risks. The most common problems include bleeding, bruising, or infection at the entry site. In rare cases, complications such as heart rhythm disorders, allergic reactions, or vessel rupture may develop. Serious side effects are very rare.
Temporary deterioration in kidney functions may develop due to contrast material, especially in those with kidney problems beforehand, this risk increases. The risk of heart attack or stroke during the procedure is very low but not completely zero. Therefore, angiography must be performed by a specialist team.
How Are Angiography Results Evaluated?
Images taken after angiography provide clear information about the condition of vessel structures. If there is vessel blockage, the location, size, and affected area of the blockage are determined. While medical treatment may be sufficient for mild narrowing, stent or bypass may be required for serious narrowing. This decision is made by joint evaluation of the cardiologist and cardiovascular surgeon.
Angiography results are often interpreted shortly after the procedure. Your physician will meet with you one-on-one to explain details about your vascular health and plan the next steps. When evaluated together with risk factors, these results guide many decisions from lifestyle changes to surgery.
When Should You Consult a Doctor?
The recovery process after angiography usually progresses without problems. However, in some cases, you need to consult a physician without delay.
You should consult your doctor in the following situations:
- Excessive swelling, bleeding, or redness at the entry site
- Persistent chest pain
- High fever
- Numbness, coldness, or color change in the leg
Frequently Asked Questions
Is angiography a painful procedure?
No, the procedure is performed with local anesthesia. You may feel slight pressure at the entry site, but there is no serious pain.
How long does angiography take?
Angiographies performed only for diagnostic purposes usually take 15-30 minutes. If treatment is also to be performed, the duration may be extended.
Can angiography be repeated?
Angiography can be repeated when necessary. It can be performed again for stent controls. It can be used for graft control after bypass. Re-evaluation can be performed if new symptoms develop.
Is contrast material harmful?
Contrast material is generally safe. It is excreted through the kidneys. Drinking plenty of water accelerates excretion. It is used carefully in kidney patients. The risk of allergic reaction is low.
Is there an age limit for angiography?
There is no definite age limit for angiography. It can also be performed in children. Careful evaluation is made in elderly patients. Kidney functions are important. Risk-benefit analysis is performed.
Reference: Angiography
