How is coronary angiography done?

Which is better, coronary angiography or coronary CTA?

Source | Heart Health

Ms. Liu went to the hospital because of her recent chest tightness and discomfort. As a result, she hung up two numbers in the department of cardiology. One doctor suggested that Ms. Liu have a coronary angiography, and another doctor suggested that Ms. Liu have a coronary CTA. This time, Ms. Liu was very worried. She left me a message backstage and asked me whether to do angiography or CT. Today, let's discuss which is better, coronary angiography or coronary CTA.

Coronary CTA and coronary angiography are both important means to evaluate whether there is coronary heart disease and guide treatment. Both of them have their own advantages and disadvantages, and the choice of different examination methods needs to be determined according to the situation. It is still inconclusive whether coronary CTA or coronary angiography is better. Need specific analysis of specific problems.

1

Coronary CTA

■ What is coronary CTA?

Coronary CTA is a noninvasive coronary artery examination. The main principle of the examination is that the contrast agent is injected into the coronary artery quickly with a high-pressure syringe, and then the coronary artery image is generated by using CT fast multi-slice scanning and image reconstruction technology, so that the lesion site and stenosis degree of the coronary artery can be basically understood.

■ What are the advantages of coronary CTA?

1. Non-invasive: Coronary CTA is a "non-invasive, rapid and accurate" method for coronary heart disease examination, which has become the gospel of many patients who need to know about coronary artery conditions. Compared with human coronary angiography, the biggest advantage of cardiac CT is non-invasive.

2. Better evaluation of plaque: Of course, apart from non-invasive, compared with coronary angiography, cardiac CT has advantages in measuring the load of coronary artery calcified plaque, understanding the situation of coronary artery wall and outside coronary artery, and checking congenital coronary dysplasia.

3. Less risk: Compared with coronary angiography, coronary CTA has less risk because it is non-invasive and has no invasive operation.

4. Lower cost: Coronary CTA is much cheaper than coronary angiography, and it is safer and has fewer side effects.

■ What are the disadvantages of coronary CTA?

The 1. image is static, which is worse than coronary angiography.

2. Higher requirements for heart rate and surgical reconstruction;

3. It is greatly influenced by vascular calcification;

4. Because it is a static image, it is impossible to evaluate the blood flow and its direction.

2

Coronary angiography

■ What is coronary angiography?

Coronary angiography is a common method to check whether the coronary artery is normal. It is an invasive operation, which needs to send the contrast catheter to the ascending aorta through the peripheral artery and then to the opening of the coronary artery, so as to inject the contrast agent statically and develop the coronary artery. Coronary angiography is also called the "gold standard" for the diagnosis of coronary heart disease.

■ What are the advantages of coronary angiography?

1. Dynamic multi-angle display of blood vessels is more accurate for lesion evaluation and can also provide more accurate guidance for treatment.

2. The requirements for heart rate and other conditions are low, which is suitable for more people to do comparative examination.

3. You can directly intervene in the treatment, and it is safer and more effective to treat while checking.

4. It is less affected by vascular calcification and can better judge the blood flow direction and blood flow situation.

■ What are the disadvantages of coronary angiography?

1. invasive procedure: patients may feel more uncomfortable because of the need to send contrast catheter into the coronary artery opening.

2. Greater risk: Because it is an invasive operation, the risk is greater and there may be more complications.

3. Higher cost: Compared with coronary CTA, the cost is higher.

4. Can't reflect the condition of blood vessel wall and plaque: Compared with coronary artery ctA, the condition of blood vessel wall is not as good as CT.

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Do you choose CT or angiography?

1. Angiography is the first choice for patients with definite discomfort caused by coronary heart disease, and CTA is the first choice for patients with unexplained chest discomfort.

2. CTA is the first choice when coronary artery needs to be evaluated in the proposed operation.

3. Angiography is the first choice when coronary intervention or coronary surgery is planned.

4. Coronary angiography is the first choice for patients with clinically diagnosed or highly suspected coronary heart disease.

5.CTA is the first choice to evaluate the bridge vessels in patients with bypass grafting.

6. Angiography is the first choice to evaluate the interventional effect or stent effect and the situation after thrombolysis.

There are actually so many descriptions. Simply put, angiography is the first choice for patients who need further treatment and have original clarity. Secondly, CT can be the first choice for evaluation.

The easiest way is actually to follow the doctor's advice. Because doctors need to know your situation in different dimensions, they need to do different tests. Sometimes, we need to do coronary CTA and angiography at the same time to better judge what to do next.

As for Ms. Liu, some people suggested CT and others suggested angiography. It should be that the doctors who suggest CT are more inclined to think that Ms. Liu is not like coronary heart disease, while the doctors who suggest angiography may be more inclined to think that Ms. Liu is more like coronary heart disease.