Angiography and angioplasty: unveiling their roles in coronary artery disease

When navigating cardiac health, it is important to understand the many methods of testing and treatment available. A variety of complicated procedures may be used to diagnose and treat coronary artery disease, cardiomyopathies, heart failure or other cardiovascular problems. This article will discuss the difference between angioplasty and angiography, and highlight how they are related. It will also describe the processes of coronary angiography, coronary angioplasty, and coronary stenting, and provide necessary information for patients undergoing these procedures.

 

Angiograms and arteriograms

Coronary angiography is a type of X-ray diagnostic procedure used particularly to view the heart’s coronary arteries since blood vessels cannot be seen by a normal X-ray. The angiography diagnostic procedure is conducted to see if the blood vessels exhibit any narrowing or blockages.

In addition to its application in coronary assessment, angiography procedures can be extended to investigate and diagnose conditions such atherosclerosis, peripheral arterial disease, brain aneurysms, or pulmonary embolisms, particularly when exploring vascular territories beyond the coronary tree. The resulting diagnostic X-ray images from this procedure are referred to as angiograms or arteriograms.

 

Is an angiography considered surgery

While the angiography itself is not classified as surgery, it is a diagnostic procedure commonly utilized to assess the condition of the coronary arteries, often guiding to subsequent treatments. The angiography serves both diagnostic and therapeutic purposes. During the procedure, the patient is typically sedated with local anesthesia, and access is established either through the radial or femoral artery. Catheters and wires are then introduced into the arterial system, and a contrast agent is injected into the bloodstream. This process highlights the blood vessels on on X-ray images, allowing doctors to identify any blockages or narrowing of arteries.

Cardiac Catheterization - What Is Cardiac Catheterization | NHLBI, NIH

image from https://www.nhlbi.nih.gov/health/cardiac-catheterization

What is angioplasty?  

To open the blocked or narrowed arteries, angioplasty may be performed on a patient as treatment. Angioplasty is a treatment method employed to address blocked or narrowed arteries. Unlike open-heart surgery, coronary angioplasty is a minimally invasive procedure. In this process, a cardiologist inserts a catheter into the radial or femoral artery, guiding it to the coronary artery. Through the catheter, a thin metallic wire is advanced beyond coronary obstruction. A catheter with a small balloon at its tip is then positioned over this wire, targeting the diseased area of the vessel. Upon inflation, the balloon pushes the plaque or blood clot to the sides of the artery. This will condition the blood vessels to allow for better blood flow. 

Typically, a coronary angioplasty involves the placement of a stent– a tubular, expandable metal piece of mesh. The stent, mounted over a balloon, expands upon inflation. The primary objective of coronary stents is to keep the artery open and prevent narrowing or occlusion post-treatment. 

Angioplasty and stenting – CIRSE

Image from https://www.cirse.org/patients/general-information/ir-procedures/angioplasty-and-stenting/

What is the difference between angiogram vs angioplasty?

In brief, an angiography is a diagnostic procedure, while angioplasty is the corresponding treatment for coronary artery disease.

 

Can an angiography and angioplasty be done at the same time? 

Regarding the distinction between angioplasty and angiography, both are components of a set of tests and treatments called cardiac catheterization and can conducted concurrently. Once an angiogram is obtained, the cardiologist can use the diagnostic to perform angioplasty. The real-time images reveal the blocked or narrowed areas, guiding the cardiologist in determining where to conduct the angioplasty and place the stent. Depending on the situation, the cardiologist may opt for an alternative treatment or a combination of treatments following the angiography. In some cases, an atherectomy may precede angioplasty to create space for the insertion of a balloon. This involves using a catheter with a rotating tip at the narrowed artery point to break or cut away plaque, restoring blood flow.

 

Making the right choice for your cardiovascular health 

To make informed decisions about cardiovascular health, it is crucial to understand the difference between angioplasty and angiography. While these procedures can be life-saving, there remains potential for future complications, including stent restenosis, fracture, or thrombosis. Therefore, it is paramount to adhere to the clinical checkups prescribed by specialists following these procedures. 

Angioplasty and stenting entail certain risks and many potential side effects. To mitigate the risk of further cardiovascular issues or stent complications, we encourage you to check out our blog and read about Post Coronary Stent Care.

Some hospitals conduct 6-month follow-ups after stent placement to monitor for malfunctions and reduce the risk of heart problems. You can learn more about  How frequently you should monitor your stent after placement. 

In the event of symptoms indicating stent failure, coronary angiography may be used to ensure the stent is working properly. Read about How to recognize symptoms of sent failure.

 

Advancements in Heart Attack Monitoring: NIMBLE Diagnostics 

The technology currently available to cardiologists does not allow them to continually monitor stents. Many patients do not receive the diagnoses they need, either due to the expense and invasiveness of coronary angiography, or when they do not exhibit any apparent symptoms. 

NIMBLE Diagnostics is committed to the development, testing, and launch of its innovative NIMBLE system, designed to provide clinicians with objective data on the status of coronary stents. Using first-in-class microwave imaging, the device can monitor stents in both symptomatic and asymptomatic patients without the need for invasive angiography. This technology is quick, cost-effective, and will be widely available for patients. Unlike with current practices, patients will require no hospitalization, as the technology will be easily accessible from a clinician’s clinic. The NIMBLE system has the capacity to diagnose stent malfunctions before they escalate into serious complications such as stroke, heart attack, or sudden death.

 

Conclusion 

There are numerous steps to testing, diagnosing, and treating the various problems that may arise with a patient’s heart and coronary arteries. Given the complexity of these procedures, it is crucial to stay informed about the procedures available for cardiovascular patients. Diagnostic treatment options are constantly evolving, and new technologies are being discovered.

In this context, the NIMBLE System represents a significant advancement and offers an alternative to the cost, risk, and uncertainty associated with currently available treatments.


The information published in this Blog article, or in NIMBLE DIAGNOSTICS website, is provided for information purposes only and does not and cannot be considered as a consultation, treatment, therapy, or medical or clinical prescription, nor is it a substitute for treatment, diagnosis, therapy, or supervision by a healthcare professional. The information published is neither intended to be used as a guide and should not serve nor be used as an exclusive orientation for the healthcare professionals to make decisions about the treatment and therapy of their patients, nor does it replace the healthcare professionals’ criteria. NIMBLE DIAGNOSTICS makes no warranties as to the accuracy, suitability, or completeness of the information provided, and shall not be held responsible for any decisions made based on the information provided on this Blog article, NIMBLE DIAGNOSTICS website or any other websites linked or referenced in NIMBLE DIAGNOSTICS website.


 

Sources

https://www.mayoclinic.org/tests-procedures/coronary-angiogram/about/pac-20384904

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/angioplasty-and-stent-placement-for-the-heart#:~:text=What%20is%20angioplasty%3F,such%20as%20a%20heart%20attack.

https://www.nhs.uk/conditions/angiography/

https://vascular.org/patients-and-referring-physicians/conditions/angiogram

https://www.sydneyvascularsurgery.com.au/angioplasty-atherectomy-stenting.html#:~:text=Atherectomy%20is%20sometimes%20used%20as,which%20then%20widen%20the%20artery.

Image Citation

https://www.nhlbi.nih.gov/health/cardiac-catheterization

https://www.cirse.org/patients/general-information/ir-procedures/angioplasty-and-stenting/ 
https://www.dicardiology.com/article/recently-introduced-angiography-imaging-technologyn

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