PERCUTANEOUS TRANSLUMINAL CORONARY ARTERIOGRAPHY

Course overview

PERCUTANEOUS TRANSLUMINAL CORONARY ARTERIOGRAPHY OR INVASIVE CORONARY ANGIOGRAM IS CONSIDERED THE GOAL STANDARD INVESTIGATION TOOL TO DIAGNOSE CORONARY ARTERY DISEASE. CORONARY DISEASE IS THE LEADING CAUSE OF DEATH IN THE UNITED STATES OF AMERICA. THE FUNDAMENTAL GOAL OF A CORONARY ANGIOGRAM IS TO DEFINE THE CORONARY ANATOMY AND DETERMINE THE SEVERITY OF THE STENOSIS IN EPICARDIAL CORONARY ARTERIES OR CORONARY ARTERY BYPASS GRAFTS. THE HEART TEAM APPROACH IS ESSENTIAL FOR PERFORMING CORONARY ANGIOGRAMS AND DECIDING ON A REVASCULARIZATION STRATEGY. CORONARY ANGIOGRAM THROUGH THE RADIAL APPROACH IS ASSOCIATED WITH EARLY RECOVERY AND A LOW RISK OF ACCESS SITE BLEEDING COMPARED TO THE FEMORAL APPROACH. A CORONARY ANGIOGRAM IS RELATIVELY SAFE WITH ADVANCED CATH LAB ARMAMENTARIUM AND TECHNOLOGIES. HOWEVER, LIFE-THREATENING COMPLICATIONS CAN OCCUR OCCASIONALLY. IN GENERAL, REVASCULARIZATION CAN BE CONSIDERED IF THE ANGIOGRAPHICALLY ESTIMATED SEVERITY OF CORONARY STENOSIS IS MORE THAN 70%. IF THE STENOSIS IS BETWEEN 50-70%, IT IS RECOMMENDED TO EVALUATE THE LESION WITH PHYSIOLOGICAL ASSESSMENT, INTRAVASCULAR ULTRASOUND (IVUS), OR OPTICAL COHERENCE TOMOGRAPHY (OCT). IT WILL GUIDE INTERVENTIONAL CARDIOLOGISTS IN DETERMINING THE STENOSIS'S SEVERITY AND REVASCULARIZATION OPTIONS.