Usually coronary angiography, usually choose femoral artery, and some can also choose radial artery, but you must have a good vascular condition of radial artery. Generally, we will do Allen test first to see if your radial artery is OK. Femoral artery generally has no scruples.
Before coronary angiography, you naturally need certain conditions. For example, all your tests must be complete. If your platelets are very low, your blood coagulation function is poor, or your liver and kidney function is not good, naturally it will not work. Generally, we won't do it until the relevant inspection is perfect. There is also an iodine test to see if you are allergic. No, you need iodine preparation for imaging.
In addition, in general, we need to treat with antiplatelet preparations first, so as to reduce the chance of thrombosis. I used to use ticlopidine and aspirin, so I usually take it for three days. In recent years, ticlopidine has been replaced by clopidogrel (Boliwei), a better antiplatelet preparation. You can take 300 mg orally in the morning and do it in the afternoon.
Coronary angiography is usually a local anesthesia, and you are always awake. Of course, skin should be prepared locally in advance, and you can't eat it in advance. You should be sedated beforehand. Then the nurse will push you to the cardiac catheterization room.
After entering, the surgical site must be disinfected locally, and only the surgical site is exposed. Take the femoral artery as an example. You usually choose the right femoral artery. After local anesthesia at the root of thigh, the surgical tip should make a small incision, about 3 mm, and then puncture the femoral artery. After successful puncture, take out the syringe and insert the guide wire into the puncture needle. The purpose of this guide wire is actually to insert into the arterial sheath, which is difficult to handle without a guide wire.
In the future, according to the situation, different contrast catheters will be inserted into the coronary artery of the heart. In fact, the catheter needs to insert a guide wire before it can get there. Contrast where the catheter goes, such as the right coronary artery, then inject the contrast agent into the right coronary artery, and then with the help of X-ray digital subtraction angiography, you can see the right coronary artery on the TV screen.
If the stenosis of a single blood vessel is found to be more than 70% during angiography, we usually have a TV projection screen in the external room to talk to our family members, and it is recommended to implant stents. Of course, if the lesion is complicated and diffuse, then we suggest that surgical coronary artery bypass grafting (CABG) be performed in the future. If the family members agree, then we can implant the stent on the spot. Usually, we can dilate the local area with a balloon catheter before sending it into the stent. We can also directly put the balloon stent in and directly expand the balloon, so that the stent will be stretched. I won't say much about this.
Of course, there may be risks in the operation, such as heart rupture, coronary artery rupture, embolism and other serious problems. In addition, some non-coronary complications, such as vagal reflex, are the most common. Because of vascular stimulation, some people have poor vagus nerve function, and their blood pressure and heart rate may suddenly drop. Some patients didn't show up on the spot. After the operation, they will appear after being sent back to the ward and pulled out the sheath. However, most vagal reflex doctors are very experienced. If necessary, they can supplement normal saline and inject atropine.
In addition, the most common thing I encounter is local hematoma. Sometimes it tastes ugly, but generally it's not a big problem.
I have encountered another kind of arteriovenous fistula, not in coronary angiography, but in radiofrequency catheter ablation of cardiac electrophysiology. Anyway, the peripheral blood vessels puncture the arterial vein to form a fistula, and then they are compressed under the guidance of ultrasound and naturally closed, so there will be no problem, otherwise the surgical solution will be troublesome.
After filming, I usually lie in bed. I used to use rice bags for compression, which took a long time. Now that I have a tourniquet, I feel much more comfortable. But sometimes I always have to stay in bed for a period of time, especially when there is vagus nerve reflex, so I may have to go to the toilet after staying in bed for a long time, so I am not used to it, and sometimes it is more troublesome. I've met several cases that require your doctor to insert a catheter. It's your bad luck to insert a catheter.
After the operation, if nothing happens, I will be discharged soon, and my bed is tense. Who put you in the hospital?
In fact, it is usually like this. Don't be afraid. It's usually like the cardiology department of a big hospital. It's usually no big deal.