Coronary Angiography and Stenting - Dubai Cardiology Clinic

Coronary Angiography and Stenting

What is Coronary angiography?

It is an invasive test to visualize the coronary arteries which supply the blood and oxygen to the heart muscle to see if there is narrowing or blockage due to atherosclerosis (arteries thickening and deposits of lipid and plaque build up in the wall of the artery). DRHC's cardiology department offers angiography in Dubai. 

When does coronary angiography need to be done?

In case of  

• Angina
• Atypical chest pain with a positive exercise test
• Aortic stenosis
• Unexplained heart failure
• Heart attack (either immediately within 90 minutes of the pain or later on after 24-48 hours).

Before the test, we check kidney function and diabetes control. 

You should tell your doctor if you have:

• Allergy to seafood.
• A story of a bad reaction to contrast dye.
• Taking Sildenafil (Viagra).
• Might be pregnant for ladies.

Patients come in the morning (fasting)and leave the hospital mostly on the same night.

How do we do the test?

• Usually, we give mild sedation to relax the patient, the patient will be awake during the procedure talking with the team. We may ask the patient to hold his breath or cough. after preparing the groin or arm and under local anesthesia we do an arterial puncture (it will hurt no more than a blood test) and introduce a sheath to insert the Cather guide by a special X-ray machine into the coronary artery orifice, where we inject contrast dye to visualize the arteries by X-Ray machine.
• During the test, you may feel some chest discomfort during the injection of contrast dye and rarely nausea, and urge to urinate.  If we take a picture of the left ventricle (main pumping chamber) you will feel hot all over the body for 20 seconds.
• At the end of the test, we remove the sheath and press on the groin for 10 -15 minutes to be sure there is no bleeding. then we applied a bandage for 24 hours and asked the patient to lie quietly on his back for 6 hours, but if the Cath was done from the arm, no need to lie.
• the patient is asked to relax and drink plenty of water to eliminate contrast dye by the kidneys.

During the procedure, we assess the anatomy and pathology of the coronary artery, and depending on the result the cardiologist discusses the next step of treatment. 

Actually, there are three possibilities:

• Nonsignificant lesion (less than 50% stenosis) which requires medical treatment only.
• Severe stenosis in one or two vessels which require stenting.
• Triple vessel disease: severe narrowing in three vessels - for CABG (Surgery-cardiac bypass).

Risk of coronary angiogram

 When it is performed by the experienced team the risk is 1-2% which may be:

• Bleeding or bruising
• Blood clots
• Injury to the artery or vein (False aneurysm).

What is an interventional coronary angioplasty procedure?

It is a non-surgical approach to open and dilate stenosed and blocked coronary arteries to improve blood supply to the heart muscle.

Balloon angioplasty percutaneous trans-luminal coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI): We push the catheter with a balloon to the narrowed area and inflate it there, so the plaque compresses the artery wall to dilate the artery lumen and increase the blood flow. It has a high restenosis rate of 35%, so the Stent comes up to overcome this complication It is called Balloon angioplasty with stenting: 

Balloon angioplasty with stenting is either Primary or elective:

1 - Primary stenting when the patient has an acute heart attack. Within 90 minutes we should start the procedure to open the blocked or severely stenosed artery with a balloon then insert a stent and inflate it with another balloon to keep the lumen open.

2- Elective stenting:  is done in cases of severe stenosis in one or two arteries we can proceed to do PTCA and then stenting or in other words, if we do Cath and the patient needs stenting but he is not ready for it, we plan to do the stenting electively later on.

 During PTCI we give anticoagulation so we can keep the sheath for a few hours and the patient needs to stay in the hospital for 24 hours.

Meet our Cardiologist to learn about heart attack symptoms, signs of heart attack, types of heart attacks, different levels of heart attacks, what causes heart attacks, and healthy heart foods. Dubai Cardiology Clinic at Dr Rami Hamed Center provides you with one of the best cardiologists in Dubai for treating hypertension, heart attack, heart failure, ischemic heart disease, holter monitoring, stress tests, chest pain, and echocardiography.