A Note about Procedure Names:
The terms angiogram and angioplasty will be used throughout the guide. Angiogram is also known as Cardiac Catheterization and Coronary Angiogram. Angioplasty is also known as PCI or coronary angioplasty.
Why Is an Angiogram Necessary?
Diagnostic tests provide important information, but they do not give all the answers. Sometimes an angiogram is also necessary for the doctor to make a correct diagnosis and determine the best treatment for your heart problem.
When your doctor orders an angiogram, the necessary information is sent to the Wait List Management Office at the Ottawa Heart Institute.
There may be unforeseen delays, changes in schedule or cancellations. Due to these possibilities there may also be a change in the doctor who will perform your procedure.
Should you have any questions or concerns or you experience a change in symptoms while you are waiting at home for your angiogram, do not hesitate to call the Regional Cardiac Care Coordinator at 613-696-7000 x19733.
What Is an Angiogram?
An angiogram is a dye test used to detect heart problems. The procedure involves the insertion of a thin flexible tube (catheter) into an artery located in the groin area or the arm. The catheter is guided to the heart. Once in position, a dye is injected into the coronary arteries so that X-ray pictures can be taken. The X-rays reveal any blockages or narrowing in these arteries. The test can also look at the working of heart valves and heart muscle. Once the procedure is completed your doctor can determine the best treatment for you.
What Is Angioplasty?
Angioplasty is also known as PCI:
- Percutaneous – through the skin
- Coronary – having to do with the heart
- Intervention – the type of procedure used to open a narrowed artery
Angioplasty is similar to an angiogram. Both are done in the catheterization lab. Angioplasty is a procedure used to widen the narrowing in arteries of your heart without surgery. The basic idea is to position a catheter with a small inflatable balloon within the narrowed section of the artery. Inflating the balloon catheter causes the balloon to push outward against the narrowing and surrounding wall of the artery. This process reduces the narrowing until it no longer interferes with blood flow. The balloon is then deflated and removed from the artery. In many patients a stent is placed within the artery once it is opened.
A stent is a small metal mesh tube that is placed into your blood vessel on a balloon catheter. The stent expands against the vessel wall as the balloon is inflated. Once the balloon has been deflated and removed, the stent stays in place permanently, holding the blood vessel open and improving blood flow. Stents lower the risk of this area narrowing again. There are several types of stents available. Your doctor will select the most appropriate type of stent for your medical condition.
Angioplasty is not for everyone. Your doctor will decide if angioplasty is suitable for you.
Advantages of Angioplasty
Over 90% of angioplasties are successful immediately. Blood flow through the artery returns to normal or near normal. Some people may not have complete relief, but their symptoms are improved, allowing them to be more active and comfortable.
There is no incision as this is not surgery and you are not put to sleep (general anesthesia). Most people are up and walking on the same day. Some people go home the same day, but some patients are required to stay overnight and go home the following morning.
Disadvantages of Angioplasty
An artery may become narrow again after angioplasty. This is called restenosis. If the artery narrows enough, you may feel angina again. The use of stents has reduced the restenosis rate. Restenosis is usually treated with a second angioplasty but, occasionally, bypass surgery is needed or medical therapy is used.
Risks of Angiogram and Angioplasty
Angiogram and angioplasty (with or without stent implantation) are common procedures. Your physician has carefully considered your clinical condition and believes that the benefits of the procedure outweigh the risks. However, since these procedures are invasive there are risks associated with them.
Common risks include:
- Bleeding at the catheter insertion site or other organs due to blood thinning medication (anticoagulants)
Less common but potentially more serious risks include:
- Heart attack
- Unknown dye allergy
- Kidney problems, including kidney failure requiring dialysis
- Emergency heart surgery
- Other rare and unpredictable complications
In 1% to 2% of angioplasty cases, the artery collapses or is damaged by the wire or balloon. A stent can often fix this, but sometimes patients need emergency coronary artery bypass surgery. At the Heart Institute, our operating rooms are close by if a patient needs surgery.
Discuss the risks and benefits of your procedure with your doctor.
Angioplasty is not a cure for coronary artery disease. Coronary disease needs lifelong management. You can control your condition with a healthy lifestyle:
- Get enough exercise
- Maintain a healthy weight and reduce your waist size
- Quit smoking
You can control your risk factors by taking the medication that your doctor prescribes. Your doctor may prescribe medication for:
- High blood pressure
- High cholesterol
- High blood sugar