Interventional cardiology is a sub-specialty of cardiology that deals predominantly with the catheter based treatment of structural heart diseases.
A coronary angiogram is a procedure that uses X-ray imaging to see the inside of your heart’s blood vessels. The procedure is performed with the use of local anesthesia and intravenous sedation. A small catheter is inserted through the skin into an artery in either the groin or the arm. Guided by a special x-ray viewing instrument known as a fluoroscope, the catheter is then advanced to the opening of the blood vessels that supply blood to the heart. Then a small amount of radiographic contrast is injected into these vessels. The images produced can accurately reveal the extent and severity of all coronary artery blockages. If stenting or angioplasty is necessary it is often performed at this time.
Angioplasty is a non-surgical method of widening obstructed coronary arteries. A collapsed balloon attached to a catheter is inserted into the narrowed arteries and inflating using water pressure 75-500 times stronger than normal blood pressure. This compresses the fatty deposits lining the artery and allows more blood and oxygen to be delivered to the heart muscle. This procedure can relieve chest pain or angina and minimize or stop a heart attack.
Stents are placed in an artery during angioplasty and remain in the artery as a “scaffold”, unlike the balloon which is removed after the procedure is complete. Stents have decreased the numbers of patients needing emergency open heart to below 1%. There are different types of stents, bare-metal stents, a drug-eluting stents and covered stent. Stents cannot be used on all patients. Make sure you discuss all treatment options with your physician to determine what is best for you.
Radial Approach Angiograms
This is an angiogram done by accessing the heart through the patient’s wrist instead of groin. The recovery period is much shorter as patients can be seen standing and walking around immediately following the procedure.
Renal Angioplasty and Stents
The renal artery is the main blood vessel to the kidneys. Angioplasty of this artery can relieve a blockage without having an operation. A catheter (fine plastic tube) is inserted into the artery and a special balloon on the catheter is then inflated. This opens the blockage and allows more blood to flow through it. At this time the insertion of a tiny hollow tube called a stent may be necessary to keep the arteries open.
Iliac Angioplasty and Stents
The iliac is the main blood vessel of the lower limbs. The angioplasty and stent process is the same as mentioned above.
Subclavian Angioplasty and Stents
The subclavian arteries are the two major arteries of the upper chest, located below the collar bone. These arteries receive blood from the aorta and supply blood to your arms. The angioplasty and stent process is the same as mentioned above.
Carotid Angioplasty and Stents
The carotid arteries are the arteries which supply blood to your brain. There are two of these arteries, one on either side of your neck. Carotid artery disease is the narrowing of these arteries. If these arteries become blocked a stroke can occur. Carotid artery stenting while a newer treatment option, is less invasive than carotid endarterectomy. Carotid angioplasty and stenting is performed the same way as coronary angioplasty and stenting.
This procedure uses a tiny rotating cutting blade to open a narrowed artery and improve blood flow to or from the heart by grinding away the plaque. Often a stent is placed in the artery to prevent it from re-narrowing. This procedure is done while the patient is awake and under local pain medicine. Patients often walk within six hours after the procedure though an overnight stay at the hospital is often required.