Angiography Procedures

What Is Cardiac Catheterization?

Cardiac catheterization (also called cardiac cath or coronary angiography) is an invasive imaging procedure that allows your doctor to evaluate your heart function.

Cardiac catheterization is used to evaluate or confirm the presence of coronary artery disease (cholesterol blockages in the arteries) or heart valve problems (leakage or obstruction). Depending on the severity of these blockages, it is possible to perform angioplasty or stenting to improve circulation. In some cases, surgery may be needed to bypass a blockage.

What Is a Peripheral Angiogram?

Similar to a cardiac catheterization, a peripheral angiography is one method used to diagnose peripheral arterial disease using x-ray and IV dye.

Where Are the Procedures Performed and Who Performs Them?

Your procedure will be performed in the Cardiac Catheterization Laboratory. Angiograms are performed by a specially-trained cardiovascular invasive physician and a cardiovascular team of nurse practitioners, nurses, and technicians.

How Long Does the Procedure Last?

The angiogram procedure itself generally takes 30-60 minutes, but the preparation and recovery time add several hours. If a stent is required, additional time may be needed.

What Are the Possible Risks?

Your cardiologist will discuss the specific risks and potential benefits of the procedure with you. Some of the possible risks of cardiac catheterization include:

• Allergic reaction to the medication or contrast material used during the procedure
• Bleeding at the catheter insertion site
• Injury to the artery related to catheter insertion
• Irregular heart rhythm
• Infection
• Mild to moderate skin reactions (like a sun-burn) from x-ray exposure
• Kidney failure
• Heart attack, blood clots, stroke, or death Catheter Insertion Site Alternative Site Catheter with balloon Inflated balloon compresses the plaque Coronary Angioplasty 8 5
• Acute closure of a coronary artery (specific to cardiac catheterization)
• Tear in the artery or coronary dissection
• Emergency coronary artery bypass graft (CABG) surgery (specific to cardiac catheterization) There may be other possible risks. When you meet with your doctor, please ask questions to make sure you understand why the procedure is recommended and what all of the potential risks are.

​During the Procedure

The duration of the procedure will vary depending on the findings but will likely range from 1-2 hours. You will be positioned on an x-ray table and prepared for the procedure, which may include placing an IV, laying sterile drapes, and cleaning the site that will be accessed with the sheath. Patients are given a mild sedative at this time, which will likely cause them to become drowsy. The patient’s vital signs will be monitored very closely during this time.

Once the procedure begins, the members of the team will be wearing sterile gowns, gloves and masks. The team members will be talking to you and each other during the procedure. If you have any questions or concerns during the procedure, you may speak to the team at any time. You will be asked to remain still and not move during the procedure in order to keep you safe.

The procedure generally is not painful, but you may feel some pressure when the catheters are inserted. Prior to the sheath being placed, a local anesthetic will be injected, which could sting momentarily. The sheath is a short plastic tube that allows different types of catheters to be passed through an artery up to the coronary or peripheral arteries. This is usually done in either the wrist or the groin, which will be determined by the doctor. Once access has been achieved, the doctor will perform a cardiac catheterization, which will help guide the team as to what the best treatment will be.

After the angiogram has been done, the doctor will then recommend one of three possible plans:

1. No intervention
2. A percutaneous intervention, which may include angioplasty or the placement of a stent
3. Bypass surgery In some instances, a right heart catheterization may be recommended. This involves accessing a vein and the measurement of pressures on the right side of the heart and in the lungs.