Coronary Angiograms and Intracoronary Stent Placement

Coronary Angiograms

Our cardiologists perform coronary angiograms in the hospital cardiac catheterization laboratories. After sedating the patient with intravenous medication and applying local anesthesia, the cardiologist inserts a tube through the groin and directs a catheter through the tube towards the arteries of the heart. Dye is injected through the catheter into the coronary arteries (blood vessels supplying oxygen and nutrients to the muscle of the heart) and x-ray pictures are taken. The subsequent pictures show any blockages in the coronary arteries. A final picture of the left ventricle (pumping chamber of the heart) also provides the cardiologist with information about the valves and the overall strength of the heart.

Our cardiologists can also use the catheter to measure the pressures in the different chambers of the heart. These measurements help doctors to diagnose and evaluate congestive heart failure or a disorder called pulmonary hypertension (high blood pressure in the artery connecting the heart to the lungs).

Angioplasty

Percutaneous transluminal coronary angioplasty (PTCA) or angioplasty describes a procedure cardiologists use to open up blockages in the coronary arteries (arteries delivering blood flow to the muscle of the heart). The goal of angioplasty is to improve blood flow to the muscle of the heart and decrease pain and difficult breathing. Angioplasty also reduces the need for heart surgeries and toxic medications.

During the angioplasty, the cardiologist will insert a catheter (tube) through the artery in the groin and thread it up to the blocked artery of the heart. A wire is passed through the catheter to the area of the blockage. A thin balloon is then passed over the wire to the site of blockage and inflated to open the artery. Once the cardiologist dilates the artery, the blood flow to the cardiac muscle will improve.

Coronary Stents

The advent of coronary stents has greatly reduced the rate of recurrent blockage at the site of previous angioplasty. A stent is a thin stainless steel mesh that is mounted on the angioplasty balloon and imbedded into the wall of the artery at the time of angioplasty. Prior to the advent of stents the rate of recurrent blockage at the site of angioplasty was 40%. After the discovery and routine use of stents the rate of recurrent blockage has been reduced to 15%. The most recent stents, called drug-eluting stents are specially coated with medications, that prevent blood clots from forming in the coronary artery and further reduce the rate of recurrent blockage at the site of stent placement to about 5%.