Catheterization – Diagnostic Coronary Angiography
Diagnostic coronary angiography of the heart vessels or coronaroangiography is a modern effective method for the diagnosis of coronary artery sclerosis (or atherosclerosis) in Israel and in the world. Coronary angiography or catheterization is also used as a first-class tool for the diagnosis of pathological conditions not only in the arteries, but also in the heart.
We work with leading Israeli cardiac surgeons as heads of departments of large hospitals. These are experienced surgeons who perform a large number of coronary angiography (or angiography of heart vessels) in biggest Israeli hospitals per year.
Atherosclerosis is one of the main causes of coronary heart disease, as it causes the accumulation of fat, calcium and cholesterol in the walls of the coronary artery. As atherosclerosis develops, the walls of the coronary artery become thicker, lose their elasticity and narrow. Untreated atherosclerosis can cause coronary artery blockage, which can lead to myocardial infarction, stroke, and even death.
Diagnostic coronary angiography is also called catheterization, because it is an invasive operation in which a catheter is inserted through the main artery into the groin or arm, and passes into the coronary artery. Catheter placement is performed by an experienced Israeli surgeon under the control of radiography.
During catheterization, the doctor examines the structure of the coronary artery, vasculature, detects stenosis and blockages, if any, evaluates cardiac dysfunction, cardiac valve activity, as well as cardiac and ventricular functions.
Diagnostic coronary angiography is performed in the following cases:
• Patients suffering from chest pain during exercise.
• As a continuation of pre-performed visual tests that revealed a suspicion of atherosclerosis.
• In case of repeated complaints of chest pain.
• If there is stenosis of the large coronary artery.
• if the patients is at high risk of developing coronary heart disease. Risk factors for developing coronary heart disease include smoking, being overweight, hypertension, high cholesterol, and a family history of heart disease.
If necessary, a decision may be made to switch from diagnostic catheterization to therapeutic to solve detected problems, such as clogged arteries and stent placement (or stenting). In some cases, instead of referring the patient for diagnostic coronary angiography, he will be advised to perform non-invasive virtual catheterization or cardiac scanning (scintigraphy), which is essentially a computed tomography of the heart and coronary arteries.
Expected Results from Coronary Angiography or Catheterization in Israel
Coronary angiography is performed to diagnose and treat cardiac problems. After diagnosis, a decision can be made regarding the continuation of the optimal treatment, which will possibly solve the problem. The results of diagnostic coronary angiography will allow the cardiologist to decide which treatment is optimal for the patient.
There are 3 options for continuing treatment:
♦ Conservative drug treatment and balancing risk factors.
♦ Treatment with therapeutic catheterization and stenting of blocked vessels of the heart.
♦ Referral to coronary artery bypass grafting and / or valve replacement or correction.
How is coronary angiography or diagnostic catheterization of heart vessels in Israel performed?
Coronary angiography or diagnostic catheterization is performed in the operating room for catheterization, under local anesthesia. A briefly administered anesthetic prevents discomfort or pain during catheterization. The surgeon then inserts a thin plastic sleeve with a diameter of about 2 millimeters with a catheter through the groin or wrist. During catheterization, the doctor conducts a catheter up the aorta to its base close to the heart.
Through the catheter, the surgeon injects contrast material, iodine, which is visible in x-rays when filling the arteries. Coronary artery staining allows the catheter to easily identify areas of narrowing or obstruction of the blood vessels that interfere with proper blood supply to the heart. The whole process is displayed on screens in the operating room. If the doctor identifies problems or obstruction of the blood vessels, a decision may be made to switch from diagnostic catheterization to therapeutic coronary angiography and stenting of blocked vessels. Diagnostic coronary angiography of heart vessels can take about 10-30 minutes. At the end of the operation, the doctor removes the catheter from the artery.
Preparation for coronary angiography in Israel
First, you need to consult one of the leading Israeli doctors with a personal examination and examination of ECG images, stress test (ergometry), echocardiography ECHO, cardiac scintigraphy, cardiac MRI or virtual catheterization. The doctor will determine which of these tests will need to be performed before catheterization.
If you have a sensitivity to iodine, it is important to tell the doctor before coronary angiography, because the contrast agent is based on iodine. We also organize CBC, SMA blood tests that include kidney and liver functions, as well as blood coagulation or coagulation (PT, PTT).
In some cases, if you have comorbidities, you may need to consult / approve other specialist doctors, such as a cardiologist, if you have heart disease, a neurologist, if there has been a case of brain damage, pneumonia, or chronic lung disease, etc. We will organize those appointments as well.
Our doctor will also advise you on medications that you take on an ongoing basis.
6 hours before the procedure of coronary angiography you should fast.
Coronary angiography success rates and risks
Although catheterization is a quick and common procedure, it can still cause risks and complications. And therefore, should only be performed by an experienced Israeli doctor. Complications of diagnostic cardiac catheterization occur in approximately 1% of patients and may include bleeding, heart attack, femoral artery aneurysm, arrhythmia, damage to the kidneys with a contrast agent, and an allergic reaction to contrast material.