The American Hospital of Paris has vascular radiology and interventional cardiology rooms where diagnostic and treatment procedures can be performed back-to-back.
A coronary angiogram uses x-ray images of the coronary arteries to confirm the existence and extent of coronary disease, in order determine the most appropriate treatment. It is generally performed using a transradial approach (through the radial artery in the wrist), which allows the patient to sit up immediately and return home the same day. A thin tube called a catheter is inserted through this artery then guided to the coronary arteries, which supply blood to the heart. A contrast dye, visible on the x-ray images, is injected through the catheter. This enables the cardiologist to view the coronary artery on a screen and detect any narrowing (coronary stenosis) that may be preventing proper blood flow.
If a problem is detected
Our cardiologists use a range of techniques to determine whether an angioplasty procedure is necessary and/or to more accurately determine the type and severity of the stenosis. They include: Intravascular ultrasound (IVUS): to view the atherosclerosis inside the blood vessels and/or perform virtual histology or an intracoronary Doppler exam
Fractional Flow Reserve (FFR) to measure blood pressure and flow inside the coronary arteries: this functional evaluation of coronary lesions assesses how the stenosis is affecting blood flow by measuring and comparing pressure both before and after the stenosis.
When highly calcified lesions are detected, additional tools and methods may be used such as rotational atherectomy, shock wave balloon catheters and high-pressure balloons.
What happens during an angioplasty procedure?
When deemed necessary, an angioplasty may be performed immediately following any of the above diagnostic exams, in order to quickly restore blood flow.
An angioplasty is performed to restore blood flow inside a narrowed or obstructed coronary artery. It may also be performed as an emergency procedure following a heart attack. In most cases, the diagnostic exam and corresponding treatment can be performed back-to-back, on an outpatient basis.
A thin tube called a catheter with a balloon at its tip is inserted into an artery in the wrist or, more rarely, in the groin (femoral artery). It is then guided to the site where the narrowing or blockage has been identified in the coronary artery.
Once in place, the balloon is inflated so as to press the plaque against the artery wall and stretch the artery open in order to restore blood flow.
Most people have one or more stents inserted during their angioplasty. Stents are tiny coils of cobalt or platinum chromium which permanently hold the artery open once it has been inflated, thereby allowing the patient to maintain the benefit of the angioplasty over the long term.
Most stents are drug-eluting, or medicated, meaning they locally release small amounts of medicine in the weeks following their insertion. This prevents scar tissue from growing inside the stent and causing further artery blockage.
What to expect after the procedure
Most diagnostic and treatment procedures are performed under local anesthesia combined with sedation if necessary.
Patients benefit from our MUSICARE music therapy program which, together with the local anesthesia, ensures increased comfort and well-being during the procedures.
An anesthesiologist-intensivist is present at all times to oversee the patient’s comfort and safety throughout the procedure.
Patients admitted for a coronary angiogram and/or coronary angioplasty register with an online program allowing them to be monitored at all times by their doctor and to receive advice about the behaviors they must adopt to facilitate a fast recovery.