Angiography
- A coronary catheterization (coronarography) is a minimally invasive procedure to access the coronary circulation and blood filled chambers of the heart using a catheter. It is performed for both diagnostic and interventional (treatment) purposes.
- The patient being examined or treated is usually awake during catheterization, ideally with only local anaesthesia such as lidocaine .Coronary catheterization is performed in a catheterization lab, usually located within a hospital , in a sterile environment provided special equipment (angiographer) that uses X-rays. The patient is lying on the special bed and covered with a sterile field, which leaves uncovered just the right (or left) inguinal area or the radial area, where the local anesthesia is performed. Thereafter a cannula is introduced in the femoral/radial artery, into which catheters are introduced (specific long thread-like devices), which are pushed toward the coronaries, inside which they the contrast substance is injected, in order to evidence the coronaries.
- There are 3 types of treatment:
- medical treatment
- coronary angioplasty (an interventional procedure for widening of a coronary artery in the case where it is blocked or narrowed by an atheroma plaque. This intervention may be performer by balloon dilation or by stent placement)
- surgical intervention for coronary bypass
- The first revolution in the field of revascularization was Balloon percutaneous angioplasty (PTCA = Percutaneous Coronary Angioplasty) .First patient who underwent the first transluminal coronary angioplasty on September 16, 1977 by Andreas Roland Grüntzig was a German cardiologist who first developed successful balloon angioplasty for expanding lumens of narrowed arteries.
- The second revolution in interventional cardiology was bare metal stents (BMS).First-in-Man stent deployed in mid RCA by Dr. Eduardo Sousa in St. Paulo,Brazil.1988
- The third revolution in interventional cardiology was drug eluting stents(DES).In 2001, drug-eluting stents (DES) were introduced as a strategy to minimize restenosis and requirement for reintervention . FDA Approved 2003
- The fourth revolution in interventional cardiology was bioabsorbable vascular scaffold(BVS).The advantages of bioabsorbable vascular scaffold (BVS)stents
- A reduction in adverse events such as ST.
- The removal, through bioabsorption, of the rigid caging of the stented vessel.
- A reduction in bleeding complications.
- An improvement in future treatment options.
- Allowing the use of noninvasive imaging techniques such as computed tomography (CT) angiography or magnetic resonance imaging for follow-up.
- Reservoir for the local delivery of drugs and genes.
- Elimination of the concern that some patients have at the thought of having an implant in their bodies for the rest of their lives.
