All You Need To Know About Angiography & Angioplasty.
What is Angiography?
Angiography is a procedure to see the lumen of coronary arteries with the help of tube like structure
known as catheter. These coronary arteries supply blood to the muscles of the heart. This procedure is
done through the artery of either hand or thigh.
What are the indications of Coronary Angiography?
In case of heart attack or angina to see the obstruction in coronary arteries.
What is Angioplasty?
When there is significant obstruction in the lumen of coronary arteries, to clear these obstructions with
the help of balloon and/or stent is known as angioplasty. It is done the same way as the Angiography
through the artery of either hand or thigh. Angioplasty is not just putting the stent in coronary artery
but it is a process in which first catheter is passes through artery of hand or thigh to engage the Ostia of
coronary artery, then a wire is advanced in Coronary artery across the obstruction to be treated. Then
balloon passes on this wire to dilate the obstruction and finally stent is put across the obstruction on
same wire.
What is Primary Angioplasty?
When there is acute heart attack, and there is particular type of ECG changes known as ST elevation, to
open the blocked coronary artery with angioplasty within the 12 hour (preferably within 6 hour) of
onset of chest pain with the aim of maximum salvage of heart muscle is known as primary angioplasty.
What are the advantages of Primary Angioplasty?
When there is heart attack, as the time passes, more and more number of heart muscles will die due to lack of blood supply. So to minimize this damage we have to open the blocked artery as early as possible. It is a well-known fact and also proved in lots number of studies worldwide that if blocked artery is open within 3-6 hour of heart attack, damage to heart muscle will be minimum. As the extent of muscle damage increases, the pumping capacity of heart decreases, and patient develop breathlessness and other symptoms of heart failure. So to minimize the harm of acute heart attack primary angioplasty is the best treatment strategy worldwide.
Is Angioplasty is safe for patients?
Yes, any treatment modality is used on the patient when it is necessary and risk benefit ratio favor benefit significantly. Angioplasty is safe procedure and must be done when needed, but as like any other procedure, it also has some inherent complications in 2%-3% of cases.
What are the complications of Angioplasty?
There are 2 types of complications: early and late
Early complications occur during procedure or within 24- 48 hours of procedure. They are:
- Bleeding, swelling, pain and blackening of hand or thigh
- Dissection or perforation of coronary artery
- Loss of flow of blood in coronary artery
- Total occlusion of stent
- Stroke(paralysis)
- Kidney failure , in rare cases hemodialysis may required
- Arrhythmias
In 1-2 % of cases patient may die due to above complications
Approximately 2 % will develop restenosis (blockage with in stent again) within 6-12 months.
Bleeding from any site due medication given after angioplasty in 1-2 %, although major bleeding is very
less.
And lastly we have to know very clearly that angioplasty is a treatment to open the blocked artery to
prevent future complication , but it does not treat the disease , for which patient must be on regular
treatment as prescribed by treating doctor to minimize further attack.
Dr. Ambukeshwar Singh
DM Cardiology
Consultant and International cardiologist
Divine Heart and Multispecialty hospital Lucknow
