An angiography procedure in iran, also known as an angiogram, is an X-Ray test that makes use of a dye along with a camera in order to take clear pictures of the circulation of blood inside a vein or an artery. This procedure can be performed for the veins or the arteries of the chest, back, arms, head, belly and the legs.
The most common angiograms in iran: include pulmonary angiogram (of the chest), coronary angiogram (of the heart), cerebral angiogram (of the brain), carotid angiogram (of the neck and the head), peripheral angiogram (of the arms and legs) and aortogram (of the aorta).
An angiogram is used to detect aneurysms (bulge within the blood vessels). Any blockage or narrowing of the blood vessels that affect proper blood flow can also be detected by this procedure. The possibility of a coronary artery disorder being present, as well as its condition, can be determined by this technique.
Who is eligible for the treatment? (When is the treatment done?)
An angiogram or angiography is recommended in the following scenarios:
Coronary artery disorder symptoms show up, such as angina (chest pain)
Unexplained pain in the arms, neck or the jaws
Unstable angina (chest pain that has suddenly started or is increasing with time)
Congenital heart conditions
Chest injury or other conditions related to the blood vessels
A problem of the valves of the heart that warrants surgery
No non-eligibility criterion as such, however:
Since the procedure does entail its share of risks, usually, the doctor will ask you wait before deciding on an angiogram if other non-invasive testing procedures haven’t been performed or haven’t come up with their results. Such tests include an echocardiogram, stress test or an ECG.
In some cases, coronary angiograms are performed on an emergency basis. More commonly, though, they're scheduled in advance, giving you time to prepare.
Angiograms are performed in the catheterization (cath) lab of a hospital. Usually you go to the hospital the morning of the procedure. Your health care team will give you specific instructions and talk to you about any medications you take. General guidelines include:
Don't eat or drink anything after midnight the day before your angiogram. Angiograms are often scheduled during the morning hours.
Take all your medications to the hospital with you in their original bottles. Ask your doctor about whether or not to take your usual morning medications.
If you have diabetes, ask your doctor if you should take insulin or other oral medications before your angiogram.
Before your angiogram procedure starts, your health care team will review your medical history, including allergies and medications you take. The team may perform a physical exam and check your vital signs — blood pressure and pulse. You empty your bladder and change into a hospital gown. You may have to remove contact lenses, eyeglasses, jewelry and hairpins.
The patient/attender consent is obtained before the procedure after briefing the process of angiogram.
You will be instructed to lie on the X-ray table, usually on your back. You may have a needle put into a vein in your arm, so that the Cardiologist can give you a sedative or painkillers. You may have a monitoring device attached to your chest and finger, and may be given oxygen through small tubes in your nose.
The skin near the point of insertion, probably the arm or groin, will be cleaned with antiseptic, and then the rest of your body will be covered with a theatre towel.
The skin and deep tissues over the artery will be numb due to the local anaesthetic and a needle will be injected into the artery. Once the Cardiologist is satisfied that this is correctly positioned, a guide wire is placed through the needle, and into the artery. Then the needle is withdrawn, allowing a fine plastic tube called a catheter to be placed over the wire and into the artery.
The Cardiologist uses the X-ray equipment to make sure that the catheter and the wire are placed at the right position and then the wire is withdrawn.
A special dye, contrast medium, is then injected through the catheter and X-rays are taken. The dye is easy to see on X-ray images. As it travels through your blood vessels, your doctor can notice its flow and identify any blockages or constricted areas.
Depending on what your doctor discovers during your angiogram, you may have additional catheter procedures at the same time, such as a balloon angioplasty or a stent placement to open up a narrowed artery.
Once the Cardiologist ascertains all the appropriate X-rays results and all the information required has been obtained from the patient, the catheter will be removed.
Every patient situation is different, and it is not always easy to predict how complex or how straightforward the procedure will be. Depending on the location of the procedure, for example, if using a large artery in the leg, this could take 45 minutes to an hour and if using smaller arteries it may be more complex and take longer. As a guide expect to be in the X-ray room for two hours altogether and the average fluoro time is less than 10 minutes.
You will be taken back to your recovery area on a wheelchair/stretcher. Nurses will carry out routine observations, such as measuring your pulse count and checking blood pressure levels, to make sure that there are no problems. They will also have a look at the incision to make sure there is no bleeding from it. You will generally stay in bed for a few hours, until you have recovered. You may be allowed to go back home on the same day, or kept in hospital overnight.
Daycare Angiograms at Apollo Hospitals are focussed to enhance patient delight, lesser stay at the hospital and hassle-free care to get discharged the same day.
As with most procedures done on your heart and blood vessels, a coronary angiogram has some risks. Major complications are rare, though. Potential risks and complications include:
Injury to the catheterized artery
Irregular heart rhythms (arrhythmias)
Allergic reactions to the dye or medications used during the procedure
A tear in your heart or artery
Radiation exposure from the X-rays
An angiogram can show doctors what's wrong with your blood vessels. It can:
Show how many of your coronary arteries are blocked or narrowed by fatty plaques (atherosclerosis)
Pinpoint where blockages are located in your blood vessels
Show how much blood flow is blocked through your blood vessels
Check the results of previous coronary bypass surgery
Check the blood flow through your heart and blood vessels
Knowing this information can help your doctor determine what treatment is best for you and how much danger your heart condition poses to your health. Based on your results, your doctor may decide, for instance, that you would benefit from having coronary angioplasty to help unblock clogged arteries. It's also possible that angioplasty or stenting could be done during your angiogram to avoid needing another procedure.