Coronary artery is the life line of our heart since it brings oxygenated blood and minerals to the heart. Our heart is the custodian of our life as it pumps oxygenated blood to our entire body throughout life. Blood supply to the heart may get impaired if the coronary artery gets clogged. Coronary artery disease (CAD) is a serious heart ailment and needs to be evaluated properly to plan appropriate therapy. Heart disease could be suspected from the symptoms like chest pain and breathlessness associated with abnormal electrocardiogram (ECG), echocardiography and tread mill test (TMT). If there is any suspicion of heart disease that needs to be conformed by coronary angiography and further management depends on the type of blockages revealed by angiography.
Coronary angiography procedure is performed under local anesthesia, in a cardiac catheterization laboratory equipped with x-ray machine and ultrasonography machine. Local anesthetic is injected into the skin just above the blood vessel to numb the area at the wrist. A special type of cardiac catheter is inserted through the radial artery of the wrist. The conventional procedure carried out earlier was through the femoral artery of the groin region. The only pain experienced by the patient is that of the injection of local anesthetic. The catheter does not hurt at all. The tip of the catheter is pushed just inside the coronary artery and then radio opaque dye is injected through the catheter into the artery. Several x-ray films are exposed rapidly as the dye is injected and recorded as a moving picture called angiogram. The procedure demonstrates the radio opaque dye passing through the coronary artery and thereby any narrowing or blockage of the artery. The catheter is pulled out gently after the procedure is over and the site of insertion is kept pressed for at least 10 minutes to avoid any bleeding and let the wound sealed with blood clot.
Trans radial coronary angiography is less time consuming and emotional stress free as compared to coronary angiography through the femoral artery route. The patient needs not to be hospitalized. There are minimal chances of infection since our arms are cleaner as compared to groin area. Patient can go home within hours after the procedure. However, trans radial coronary angiography needs more expertise for the cardiologist. There is minimal scope for serious complications.
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