?What is Angiography
.Introduction
Coronary angiography is a fundamental procedure in cardiovascular medicine that provides unparalleled insight into the structural and functional integrity of the coronary arteries. This article clarifies the principles, indications, procedural aspects, and clinical significance of coronary angiography in modern medicine
Pathophysiological Basis
Coronary angiography is essential to visualize the coronary arteries and distinguish between luminal stenosis, occlusion, and evidence of atherosclerotic plaque burden. The differentiated media intravascular tissue achieves the anatomic contour of the coronary artery course and facilitates accurate assessment of the severity of coronary artery disease (CAD)
.Indications
The diagnostic field of coronary angiography encompasses a myriad of clinical situations. The main ones are the evaluation of angina pectoris, acute coronary syndromes (ACS), myocardial ischemia, preoperative risk stratification for cardiac surgery, and surveillance of known cases of CAD. In addition, coronary angiography is useful in the diagnosis of congenital coronary artery anomalies and in the evaluation of suspected coronary artery vasculitis
Procedural Considerations
Coronary angiography requires careful preparation and adherence to standardized protocols. Patients should be placed on a strict fast before meals, and careful attention should be paid to drug therapy. The choice of access site is primarily femoral or radial, but depends on the patient's anatomy and the surgeon's preference. After arterial access, intravenous sedation or general anesthesia is administered to ensure patient comfort during the procedure. Fluoroscopic catheterization and contrast injection facilitate comprehensive visualization of the coronary arteries
Procedural Complications
Despite advances in technique and equipment, coronary angiography carries inherent risks. Complications at the vascular access site, including hematoma formation and pseudoaneurysms, are prominent problems. In addition, contrast nephropathy, allergic reactions to contrast media, and embolic phenomena remain potential complications. Careful monitoring and prompt recognition of adverse events are essential to reduce the risks of the procedure
Post-procedure care
Meticulous care after coronary angiography is paramount to optimizing patient outcomes. To reduce the risk of access site complications, hemostasis at the arterial access site can be achieved by manual compression or vascular closure devices. Careful monitoring for signs of contrast-induced nephropathy or allergic reactions is essential immediately after the procedure. In addition, patient education regarding activity restrictions, medication compliance, and follow-up care is necessary to promote optimal recovery
Clinical Utility
The diagnostic utility of coronary angiography extends beyond anatomic delineation to prognostic stratification and therapeutic intervention. Identification of hemodynamically significant coronary lesions can guide therapeutic decisions such as percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG). In addition, assessment of coronary lesion function by adjunctive techniques such as fractional flow reserve (FFR) can help determine the appropriateness of revascularization strategies
RESULTS
Coronary angiography, an important diagnostic tool for cardiovascular therapy, provides unparalleled insight into the anatomic and functional health of the coronary arteries. Coronary angiography is essential for the diagnosis and treatment of CAD and provides the best possible outcome for patients with cardiovascular disease through careful surgical planning, careful monitoring, and careful interpretation of results
