Intravascular Ultrasound Technique: An Alternate To Coronary Angiography (Super Simplified Edition)

INTRAVASCULAR ULTRASOUND TECHNIQUE
An alternate to Coronary Angiography

(Super Simplified Edition)
By:- Taanish Kumaar

Dedicated to
My parents & you.
To understand alternative approach to Coronary Angiography,
we should first know what actually is coronary angiography?
CORONARY ANGIOGRAPHY
In simple words coronary angiography is a procedure that
uses a special dye and x-rays to see how blood flows through
the arteries in your heart.
During coronary angiography, local anaesthetic are given to
the patient and then a catheter is put into an artery in groin,
or at the inside of patients elbow or near his/her wrist. The
catheter is moved up the inside of artery until it reaches the
heart. A special dye is then injected into coronary arteries and
X-rays are taken. The X-ray image (a ‘coronary angiogram*’)
gives detailed information about the state of your patients
heart and coronary arteries.
CORONARY ANGIOGRAM
Image adapted from www.heartfoundation.org
CORONARY ANGIOGRAM is an X-ray image of blood vessels

after they are filled with a contrast material. Typically 3–8 cc
of the radiocontrast agent ie. X ray dye is injected for each
image to make the blood flow visible for about 3–5 seconds as
the radiocontrast agent is rapidly washed away. Angiographic
images accurately reveal the extent and severity of all
coronary artery blockages.
Now the question arises how do you know if you need
angiography or not ?
Of course patient would need a physician’s consultation for
that but the most common reason for which someone visits a
doctor is pain (that may be angina pain*)
Angina Pain :The usual cause of angina is narrowing of one or
more of your heart (coronary) arteries. This reduces the blood
supply to a part or parts of your heart muscle.
Procedure
• After basic steps are performed(the arm or groin is

cleaned and numbed with a local anaesthetic) a catheter
( commonly 6-French) is inserted through the skin into
an artery in either the groin or the arm.

• Catheter will be then moved through the aorta, to the
beginning of the coronary arteries of heart. Its progress
is watched via X-rays shown on a monitor.
• Once the catheter is in place, dye is injected into the
catheter. X-ray images are taken to see how the dye
moves through the artery. The dye helps highlight any
blockages in blood flow.
• The dye is later eliminated from body through kidneys
and urine
• Procedure usually lasts 30 to 60 minutes
• Physician will explain the results of the test. The
information about patients heart and coronary arteries
will help doctor to recommend the best treatment.
• Or If the pictures from your angiography show a
narrowing or blockage that can be treated immediately,
your cardiologist may decide to continue and put a stent
in at once as part of the same procedure
critical sub-occlusion of the common trunk of the left
coronary artery and the circumflex artery.(image adapted
from biomedcentral.com)
Risks involved
If I say that this is a risk free diagnostic procedure then

probably I am wrong given are few observations adapted from
myhealth.alberta.ca
Beside this certain health conditions can raise your risk of
having problems after angioplasty. Conditions that can raise
the risk of death from the procedure include heart failure,
heart valve problems, and chronic kidney disease. The risk of
heart attack may be higher if you have heart disease in the
left main coronary artery.
Alternative Methods
CT angiography can act as a less invasive alternative to

Catheter angiography. Instead of a catheter being inserted
into a vein or artery, CT angiography involves only the
injection of a CT-visible dye into the arm or hand via an IV
line. CT angiography lowers the risk of infection & arterial
perforation
Though there are few draw backs of this procedure too, you
must have heard about incidents where doctors perform
angioplasty at the same time of angiography ,Catheter
angiography gives the ease to perform procedure such
as balloon angioplasty or insertion of stent .
But here I would be primarily focusing on Intravascular

ultrasound technique (IVUS)
In IVUS a specially designed catheter with a
miniaturized ultrasound probe attached to the distal end
of the catheter. The proximal end of the catheter is
attached to computerized ultrasound equipment. It
allows the application of ultrasound technology, to see
from inside blood vessels out through the
surrounding blood column, visualizing
the endothelium of blood vessels.
IVUS images show the artery walls and can reveal
cholesterol and fat deposits
Adapted from Novel Pathophysiological Insights and

Current Clinical Applications Steven E. Nissen, MD;
Paul Yock, MD
Procedure
• An intravenous (IV) line into a vein of hand or

arm so that sedative medication can be given
intravenously. Moderate sedation may be used.
As an alternative, you may receive general
anaesthesia.
• A sheath is first inserted into an artery or a
vein. Using x-ray or ultrasound guidance, the
catheter is inserted into the sheath and gently
maneuvered through the vessel to the target
location. Once in place, the transducer on the
end of the catheter uses sound waves to
produce pictures of the blood vessels. Doctors
can move the catheter to get pictures of the
inside of the vessels at different locations.
An intravenous line
Advantages of Ultrasound
• Arguably the most valuable use of IVUS is to visualize

plaque, penetrating nature of ultrasound provides
unique images of the atherosclerotic plaque, not
merely the lumen which cannot be seen by
angiography
• The tomographic orientation of ultrasound enables a
visualization of the full circumference of the vessel
wall, not just two surfaces.
• The ultrasound test can also be used to rule out the
diagnosis of CAD in patients with reduced heart pump
function.
• Cost efficient & Out patient procedure
References
• https://www.heartfoundation.org.nz/your-
heart/heart-tests/coronary-angiography
• health/report-ultrasound-technique-better-
alternative-to-invasive-angiography-for-
diagnosing-heart-disease-1396728
• https://medlineplus.gov/ency/article/003876.ht
m
• Intravascular Ultrasound
• Novel Pathophysiological Insights and
Current Clinical Applications Steven E.
Nissen, MD; Paul Yock, MD
• Procedural Techniques of Coronary
Angiography Jasmin Čaluk BH Heart Center
Tuzla Bosnia-Herzegovina

Intravascular Ultrasound Technique: An Alternate To Coronary Angiography (Super Simplified Edition)

Uploaded by

Copyright:

Available Formats

Intravascular Ultrasound Technique: An Alternate To Coronary Angiography (Super Simplified Edition)

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Intravascular Ultrasound Technique: An Alternate To Coronary Angiography (Super Simplified Edition)

Uploaded by

Copyright:

Available Formats

INTRAVASCULAR ULTRASOUND TECHNIQUE

An alternate to Coronary Angiography

By:- Taanish Kumaar

Image adapted from www.heartfoundation.org

CORONARY ANGIOGRAM is an X-ray image of blood vessels

• After basic steps are performed(the arm or groin is

an artery in either the groin or the arm.

If I say that this is a risk free diagnostic procedure then

CT angiography can act as a less invasive alternative to

But here I would be primarily focusing on Intravascular

Adapted from Novel Pathophysiological Insights and

• An intravenous (IV) line into a vein of hand or

• Arguably the most valuable use of IVUS is to visualize

You might also like