Catheterizations are performed in a Cardiac Catheterization Laboratory (Cath Lab) that is equipped with a fluoroscope (an X-ray camera), video monitors, electrocardiography unit and other monitoring equipment. Your doctor will watch the video monitor to guide the catheter through the blood vessels and position it in the heart.
The procedure can last half an hour to two hours depending on what studies and tests are needed. You are monitored continuously throughout the procedure and observed for several hours afterward. You may spend the night after the procedure in the hospital to make sure that no complications arise.
The result of a catheterization is an angiogram - a picture of your blood vessels that can reveal clogged arteries. The results of a cardiac catheterization will help your doctor decide which course of treatment is most appropriate for you.
Angioplasty, Atherectomy and Coronary Stents
During a catheterization (cath), the physician may find a heart vessel that has been narrowed by plaque. The doctor may decide that treatment is needed to remove or reduce the plaque. These treatments allow the heart muscle to receive more blood flow and oxygen. Such treatments may be done during the initial catheterization or at a later time. Treatments for narrowed vessels include the following:
PTCA (Percutaneous Transluminal Coronary Angioplasty)
A balloon catheter is used during a PTCA (commonly referred to as balloon angioplasty) to flatten the fatty plaque. The balloon catheter is threaded through a guiding catheter, which is placed in the narrowed portion of the blood vessel. The tiny balloon is then filled with fluid to flatten the plaque and squeeze it into the arterial wall. After the balloon is deflated, the doctor checks the blood flow through the area. The balloon often needs to be re-inflated several times to open the vessel.
A catheter with a special, tiny instrument is used to grind or shave the fatty plaque. The shaved plaque pieces are collected in the catheter tip or vacuumed away by a special instrument. The plaque can also be ground up so finely that the particles are allowed to float away. The method of disposal depends upon the type of catheter used. Sometimes after an atherectomy is done, a balloon angioplasty is used to flatten any plaque that remains.
A coronary stent is a metal coil or mesh device that is placed in the spot where the plaque was treated to keep the vessel open. The stent remains inside the blood vessel and new tissue grows over it. If you have a stent in place you may need to take an anticoagulant, or blood-thinning medicine, to prevent blood clots.