There are several clinical procedures used for diagnosis and intervention in suspected cases of atherosclerosis and coronary artery disease.
Coronary Angiography is a diagnostic procedure during which a catheter is guided into the coronary arteries. A contrast dye is injected through the catheter in order to demonstrate the blood flow within the coronary arteries and any narrowing within them. This diagnostic procedure is performed when arterial narrowing is suspected.
If a treatable narrowed area is found (the narrowing is not too long and occludes more than 50% of the arterial lumen), Coronary Angioplasty may be performed immediately. The catheter is used as a guide for inserting a small balloon which is inflated at the narrowed area, thereby widening the arterial lumen.
The major shortcoming of Coronary Angioplasty is the fact that the arterial walls tend to collapse again after the inflation of the balloon. Thus, Stent Implantation is often performed directly after angioplasty. The stent acts as a scaffold, maintaining arterial wall patency and preventing prolapse.
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Elective catheterization is performed when coronary artery disease is suspected (e.g., complaints of shortness of breath / chest pain during exercise) and non-invasive diagnostic tests (such as ergometry) indicate a possible disruption of cardiac blood supply. In contrast, when acute coronary syndrome or myocardial infarction is suspected, primary catheterization is performed in order to locate the obstruction, widen it with the balloon, and implant a stent.
