What is a coronary angiogram?
This is a diagnostic procedure to image the coronary arteries. A small catheter is passed via the artery in the wrist or the groin to the openings of the coronary arteries. A small amount of contrast is then injected into the coronary arteries in order to obtain images of the vessels, to ascertain the pattern and severity of coronary plaque and narrowings. Contrast is also injected into the left heart pump chamber to assess its function.
What is PCI (percutaneous coronary intervention), angioplasty and stenting?
Using the same access as coronary angiography, a guidewire is used to cross the blockage. Angioplasty equipment is then delivered over the wire to open up the blockage. This is usually first done with a small inflatable balloon (balloon angioplasty). A stent is a small metal or bioabsorbable (bioabsorbable stent) scaffold which is then implanted to keep the artery open.
These procedures only need a local anaesthetic but patients are given intravenous sedation so they are relaxed and comfortable. Some patients fall asleep but most patients are awake. A local anaesthetic is used to anaesthetise the skin over the wrist area, or groin area.
Access can be through the wrist (radial artery) or the groin (femoral artery).
Dr Chris Lim is an expert in radial artery access interventions, being one of the interventional cardiologists to introduce the procedure to Melbourne, and helped pioneer radial access and stenting at Epworth Eastern hospital. Radial access is more comfortable for the patient, and has less risk of vascular complications such as bleeding and haematoma.