Coronary Angiography

An imaging procedure performed with contrast agent given through the groin or wrist to detect narrowing or blockage in the heart vessels.

Indication

No food or drink 6-8 hours before the procedure
Physician approval for blood thinners, diabetes medications (metformin) and drugs that affect kidney function
Blood tests for contrast allergy, kidney function (creatinine) and coagulation
Shaving of the groin or wrist area and IV line placement before the procedure
Any history of allergy to iodine-containing contrast must be reported

The patient lies supine; heart rhythm, blood pressure and oxygen levels are continuously monitored
The wrist (radial) or groin (femoral) area is sterilized and local anesthesia is applied
A thin catheter is advanced from the vessel toward the heart and visualized under fluoroscopy (live X-ray)
Contrast is injected to visualize patency, narrowing or blockage of the coronary vessels
If needed, pressure measurement (FFR) or intravascular imaging (IVUS/OCT) may be performed in the same session
The catheter is removed; pressure or a closure device is applied to the access site

Bed rest of 2-4 hours for radial (wrist) approach and 4-6 hours for femoral (groin) approach
Generous fluid intake supports excretion of the contrast through the kidneys
After the procedure, the access site is observed for swelling, bleeding or bruising
Most patients can be discharged the same day or the next day
A follow-up examination and review of the results within 1-2 weeks

Bleeding, hematoma or bruising at the access site
Allergic reaction to the contrast agent or temporary impairment of kidney function
Vascular injury, pseudoaneurysm (rare)
Arrhythmia, heart attack or stroke (very rare)
Radiation exposure (low dose)

Is coronary angiography a painful procedure?

After local anesthesia, pain is generally not felt. A brief warm flush may occur when the contrast is injected.

How long does the procedure take?

Diagnostic angiography takes an average of 20-45 minutes; the duration may extend if an additional intervention is performed.

Is the wrist or groin approach better?

Current guidelines recommend the radial (wrist) approach in suitable patients due to less bleeding and faster mobilization.

When can I return to normal life after the procedure?

After a diagnostic procedure, daily life can be resumed within 1-2 days; heavy lifting should be postponed for 2-3 days.

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