Name of the Procedure:

Coronary Angiography and Stent Placement (Non-Surgical Treatment for CAD)

Summary

Coronary Angiography and Stent Placement is a minimally invasive procedure used to diagnose and treat coronary artery disease (CAD). It involves threading a catheter through blood vessels to the heart to visualize blockages, followed by placing a stent to keep the arteries open.

Purpose

Coronary Angiography is performed to identify blockages in the coronary arteries that supply blood to the heart. Stent Placement is then used to keep these arteries open, improving blood flow and reducing the risk of heart attack.

Indications

• Chest pain (angina)
• Shortness of breath
• Positive stress test results indicating potential CAD
• Evidence of reduced blood flow to the heart on imaging tests
• High risk of heart disease based on medical history and other risk factors

Preparation

• Fasting for at least 6-8 hours before the procedure
• Adjusting or stopping certain medications, as advised by the doctor
• Pre-procedure blood tests and imaging studies
• Discussing allergies, especially to contrast dye, with the healthcare team

Procedure Description

1. The patient is given a local anesthetic at the catheter insertion site, usually the groin, wrist, or arm.
2. A thin, flexible tube (catheter) is guided through the blood vessels to the coronary arteries.
3. Contrast dye is injected through the catheter, and X-ray images are taken to visualize blockages.
4. If a blockage is found, a tiny balloon attached to the catheter is inflated to widen the artery.
5. A stent (tiny mesh tube) is placed in the artery to keep it open.
6. The catheter is removed, and the insertion site is sealed.

Duration

The procedure typically takes 1-2 hours.

Setting

Performed in a hospital's cardiac catheterization laboratory (cath lab).

Personnel

• Interventional Cardiologist
• Cardiac Cath Lab Technicians
• Nurses
• Anesthesiologist or Sedation Nurse (if sedation is required)

Risks and Complications

• Bleeding or bruising at the catheter insertion site
• Infection
• Allergic reactions to contrast dye
• Damage to the blood vessel
• Heart attack or stroke (rare)
• Blood clots or restenosis (re-narrowing of the artery)

Benefits

• Improved blood flow to the heart
• Relief from symptoms such as chest pain and shortness of breath
• Reduced risk of heart attack
• Quick recovery time compared to open-heart surgery
• Immediate results and symptom relief

Recovery

• Monitoring in the recovery area for a few hours after the procedure
• Keeping the insertion site clean and dry
• Avoiding strenuous activities for a few days
• Follow-up appointments with the cardiologist for assessment and medication adjustments

Alternatives

• Lifestyle changes (diet, exercise, quitting smoking)
• Medications to manage CAD symptoms and risk factors
• Coronary artery bypass grafting (CABG) for severe cases
• Balloon angioplasty without stent placement

Patient Experience

During the procedure, patients may feel slight pressure at the insertion site or a warm sensation when the dye is injected. Post-procedure, mild discomfort or bruising at the insertion site is common. Pain management includes over-the-counter pain relievers. Most patients can resume normal activities within a few days, guided by their doctor.