Posted On Oct 12, 2022
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Angiography is a diagnostic procedure (only for testing purposes) in which doctors use X-rays or other types of imaging (CT angiogram) to get a clear picture of your blood vessels. Also known as arteriology, it is most commonly done to check for coronary artery blockage. However, doctors can do an angiography on different parts of the body, like the brain to help diagnose a stroke or the risk of a stroke, and on the kidney to detect blockages in a blood vessel. An angiogram is an image produced by angiography. It shows blood vessels and their junctions in the body, similar to a road map and reveals the blockages if any. Refer to the image below.
Angioplasty, on the other hand, is a medical treatment procedure for narrowed or blocked arteries. With angioplasty, doctors open up (stretch or widen) a blocked or narrowed artery. Moreover, a stent or tube is often placed inside the opened arteries to keep them open. Angiography used to determine the presence and extent of blockage in the arteries in and around the heart is called coronary angiography or coronary angiogram test. Similarly, the angioplasty performed to open up the arteries around the heart is called coronary angioplasty. Let’s understand what is angiography and angioplasty, angiogram procedure, angiogram cost, and angioplasty surgery. Visit Manipal Hospitals for Angioplasty surgery treatment in Bangalore.
Depending on the body part on which the test is being performed, angiography can be of different types. Some common types are:
(i) Coronary angiography for the heart (most commonly performed angiogram)
(ii) Cerebral angiography (Brain)
(iii) Pulmonary angiography for the lungs (now more commonly done using CT angiogram)
(iv) Renal angiography (Kidney)
Similarly, angioplasty can be of different types depending on the organ involved. Coronary angioplasty is the most commonly performed angioplasty surgery.
Before you understand the process of how angiograms and angioplasty are done, you should know why doctors perform these procedures. An angiogram is done for patients showing signs and symptoms of blocked, damaged or abnormal blood vessels. Angioplasty is a treatment procedure implemented for patients whose angiogram showed narrow or blocked arteries due to the formation of plaque. With the help of angioplasty, doctors create more space inside plaque-filled arteries, thus allowing more blood to get through them. This treatment can be done as an emergency procedure in a serious patient or as an elective procedure to reduce the risk of organ failure.
Angiogram and angioplasty may also be recommended in patients with congenital heart diseases, chest injuries, or valve problems. Moreover, the test is often performed to evaluate the success of coronary bypass surgery. Consult with our Interventional cardiologist in Bangalore to know more about the treatment procedures.
Angiography is done in the catheterisation lab of the cardiology department of a hospital. It is performed using a technology similar to X-ray. The detailed procedure is provided below:
The patient lies on the scanning table on their back, and the staff fastens the safety strips. After that, the doctor positions the camera over the patient to take the images from several angles.
Sedatives are administered through IV lines to reduce the pain and discomfort.
A small puncture is made in the wrist, arm, or groin area.
The doctor inserts a thin flexible tube known as a catheter through the puncture. The catheter is then taken to the area of interest and a selective injection is given.
As the dye moves along the blood vessels, the scan captures a clear image of blood flow through the arteries. This helps in identifying the site and extent of the blockage. The complete procedure takes around 20-30 minutes.
Angioplasty is a minimally invasive procedure and the initial process is almost similar to the angiogram. In this operation, the blocked blood vessel is opened using a wire and a balloon through a radial or ephemeral approach. Since the procedure involves a balloon, angioplasty is also known as balloon angioplasty and percutaneous transluminal angioplasty (PTA). The detailed procedure is provided below:
An angioplasty procedure starts with the area where the catheter enters the body, being cleaned and numbed by a medical expert. This area is typically the groin, although it can also be the wrist.
Next, the doctor inserts the catheter with a balloon attached to one end, into the artery and guides it to the place of blockage, while watching the whole thing on a monitor screen.
Once the balloon reaches the blockage, it is inflated to open up the artery by pushing the fatty deposits (plaque) buildup away from the arterial wall. So the clot is dissolved and the blockage is opened.
Usually, a stent (metal mesh) may be permanently placed inside the blocked artery after balloon angioplasty to keep the arteries open for a long time. Often, drug-coated stents are placed that slowly release the medicine in the artery to prevent blockage in the future.
Dr (Prof) Ranjan Shetty, HOD & Consultant - Interventional Cardiology, Manipal Hospitals, in the following video talks about angioplasty procedures done in the hospital including coronary angioplasty and radial angioplasty. Watch the video to know more about how the surgery is done and the facilities available in the hospital.
After the angiogram test, the patient will be transferred to a recovery room where they will be instructed to lie still on the bed for a few hours to prevent bleeding. Usually, patients are discharged from the hospital the same day although sometimes they may need to stay overnight. The angiography test results along with the angiogram image will be made available after a few days.
If the angiogram test result shows narrow or blocked arteries, doctors will prescribe angioplasty to remove the plaque and open up the arteries. After a patient undergoes angioplasty, the doctor will take out the catheters and use a bandage to cover the place where the catheters went into the skin. Then they will be transferred to a recovery room for a few hours. They might be instructed to remain in the hospital overnight. To avoid blood clots, the doctor will likely prescribe some medication. Most people tend to resume their normal activities after one week. However, in case of an emergency angioplasty for a heart attack, the patient might need to stay in the hospital for a few more days.
The treatment of blocked arteries with angiography and angioplasty has many advantages compared to traditional methods like open-heart surgery. Major benefits are:
It has fewer risks and incurs less cost.
It can reduce the risk of stroke.
Renal angioplasty can help improve the functioning of kidneys.
It helps provide immediate relief from the symptoms such as chest pain, shortness of breath, fatigue, etc.
This is a minimally invasive surgery and requires only one puncture to insert the catheter.
Since there is only one wound in angioplasty, patients recover quickly, meaning less time in the hospital and returning to their regular activities more quickly.
Angioplasty is a relatively safe surgery. Before assessing the risks, the risks and benefits of this procedure have to be weighed. Most of the time, the benefits of doing an angioplasty far outweigh the risks. However, these could be potential risks and complications:
(i) Bleeding, blood clots, abnormal heart rhythm, and narrowing of the artery again
(ii) Radiation-induced burns
(iii) Allergic reaction to the dye or to the stent
(iv) Bleeding or damage to the blood vessel
(v) Formation of blood clots and growth of scar tissues inside the stent
(vi) Heart attack, chest pain, stroke, or death
(vii) Embolization (launching of debris into the bloodstream)
Based on the clinical condition of the patient and the type of stent used, the cost of angioplasty varies. Patients are advised to contact the hospital for the exact cost of the procedure.
CT angiography and treadmill test are some alternatives to angiography. Depending on the patient’s health condition, the doctor will suggest the process that would be the best. Angioplasty is not suitable for all patients and all types of heart conditions. Not all blocks need angioplasty and stents. Some can be managed with medicines, some need angioplasty while some need surgery.
Depending on the overall health and the extent or severity of the heart disease, the doctor can recommend coronary artery bypass graft (CABG) surgery as an alternative to angioplasty. In certain conditions such as weak heart muscle, multiple severe arteries blockage, diabetes, and the main artery being narrow, doctors may recommend coronary artery bypass surgery. It is better and more effective than angiography and stents in some situations but involves open heart surgery, post-operative pain, scarring, and a longer recovery time. Book an appointment at Manipal Hospitals, the Angioplasty hospital in Bangalore for the best treatment.
Here are some frequently asked questions on angiography and angioplasty.
A: The main difference between angiography and angioplasty is that angiography is a diagnostic test used to detect blocked arteries around the heart and other organs, while angioplasty is a treatment procedure which is used to remove the detected blockages.
A: Angiography is a diagnostic test that is used to detect blockage in the arteries using X-rays. The resulting image produced by the test is called an angiogram.
A: Depending on the test results produced by angiography, if there are blocked arteries, the doctor may recommend angioplasty to remove blockages from arteries.
A: Yes, it’s possible to do both angiogram and angioplasty at the same time. For patients with stable heart disease, it’s preferable to do both procedures at the same time because technically it's easy to do it, both for the patient and the doctor, since 50% of the procedure is the same. But medically, the patient can wait. However, if the patient had a heart attack, angioplasty must be done at the same time as angiography since the time is less and any delay can be fatal.
A: Angioplasty is a safe and minimally invasive procedure which can be performed in patients over 80 years old.
A: Angioplasty is a relatively safe surgery with less recovery time. In the case of non-emergency coronary angioplasty, patients are able to return to work after a week. They can resume their normal life within a month. However, in the case of emergency angioplasty procedures, it takes a little longer to recover and patients can return to work after a month or two.
A: According to various studies, the success rate of angioplasty is around 98%. For patients whose angioplasty is unsuccessful, they are treated through bypass surgery.
A: Angioplasty is a minimally invasive surgery that requires only one puncture to put a catheter tube. Hence, it is not considered major surgery.
A: Manipal Hospital is one of the best hospitals for angioplasty and angiography. The success rate of angioplasty depends on many factors including the training and experience level of the cardiologist, system functionality (should be functional 24x7), training of nurses and helpers, availability of lab technicians (should be available at all times), and quick initiation of surgery. Manipal Hospital has got state-of-the-art technology and round-the-clock service so that patients can get treatment as soon as possible.