Coronary Angiography

Coronary angiography is a diagnostic procedure to evaluate the blood flow through the arteries with the help of dye and X-rays. It helps cardiologists detect the presence and extent of blockage in the coronary artery. If the blockage is detected in the angiography results, the cardiologists may recommend the patients undergo Percutaneous Intervention (PCI) to remove the blockage and restore blood flow.

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  • Imaging Guided PCI with OCT and IVUS: There is a significant improvement in clinical outcomes with imaging guidance during PCI. Intravascular ultrasound and optical coherence tomography are the two most common techniques used before and after PCI. The information these techniques provide before the procedure includes lesion characteristics, such as severity and plaque composition. The techniques also provide information about the results after stent placement. The spectral resolution of OCT is almost ten times greater than that of IVUS.
  • Physiology-guided PCI with FFR and IFR: Studies have reported an association between physiology-guided revascularization, whether it be in the form of Fractional Flow Reserve (FFR) or Instantaneous Wave Free Ratio (iFR), with significantly improved outcomes and improvement in symptoms compared to the PCI performed based on the angiography alone. These benefits are greatest for patients with a significantly higher burden of ischemia.
  • Complex PCI with Rotablation (Rotapro): Rotablation atherectomy is the procedure that involves opening the blocked artery and restoring the flow of blood with the help of a rotating cutting blade. The deposition of cholesterol and other substances in the coronary artery is known as plaque. If the plaque is soft, it can be easily managed through angioplasty. However, in the case of hard plaque, rRotablation atherectomy is recommended.
  • Complex PCI with Intravascular Lithotripsy (Shock Wave): This procedure is used to restore blood flow through a severely calcified coronary artery. It involves the vaporization of the fluid to form an expanding bubble. This bubble forms sonic pressure waves to interact with arterial calcification. The procedure is done by inserting a catheter and guiding it to the coronary artery.
  • Chronic Total Occlusion PCI: CTO PCI is the procedure performed to restore blood flow in the coronary artery in patients with complete coronary artery blockage. The interventionists use forward and backward-moving approaches to reach the blockage. The surgeons use several vessels to reach the blocked arteries from multiple sides.