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Coronary Angiography Imaging Procedures

Coronary angiography, or cardiac catheterization, is a procedure performed to diagnose coronary artery, or valve disease, test muscle function of the heart and determine the need for additional treatment. The procedure produces X-ray images of the blood flow in the arteries and main pumping chamber of the heart. Additional imaging procedures may be done to obtain more accurate pictures. These include intravascular ultrasound and fractional flow reserve.

  1. Cardiac Catheterization

    • Cardiac catheterization is the main procedure in cardiac angiography. A long, narrow tube, called a catheter, is inserted into a blood vessel in either the arm or leg, usually the groin. Using X-ray imaging, the catheter is advanced through the body to the heart and coronary arteries. The X-ray machine records a movie as a special dye is introduced that shows the blood flow through the chambers of the heart and its arteries. This movie shows any blockages or narrowing of the arteries. The movies and pictures are used to diagnose or rule out coronary artery disease and other cardiac problems. Further treatment may be done at the same time or at a later date.

    Intravascular Ultrasound

    • Intravascular ultrasound (IVUS), is an additional imaging procedure to obtain more detailed images of the heart and arteries. A small sound probe is introduced through the catheter and positioned in the heart near the tip of the catheter. Using high-frequency sound waves, the ultrasound machine can produce detailed images of the walls of the arteries. These images help confirm the exact location and severity of plaque in the arteries. This procedure is currently performed only in specialized treatment centers.

    Fractional Flow Reserve

    • Fractional Flow Reserve (FFR), is another procedure sometimes performed in conjunction with cardiac catheterization to obtain a more accurate diagnosis. A special wire is inserted into the catheter and through the blockage. Medicine to dilate the blood vessel is administered, and the wire measures the pressure of the blood flow. An article in "New England Journal of Medicine" showed that the use of FFR in addition to cardiac catheterization reduces the risks of certain types of heart attack and repeat treatments. Like IVUS, FFR is performed at specialized treatment centers.

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