Coronary Angiography

Performing an angiogram (also known as coronary angiography) and placing stents typically falls under the purview of an interventional cardiologist, a specialized cardiologist with advanced training in invasive procedures for diagnosing and treating cardiovascular conditions.

Here’s a breakdown of the roles and responsibilities:

Angiogram (Coronary Angiography):

Procedure:

An angiogram involves inserting a catheter into a blood vessel, usually in the groin or wrist, and threading it through the arterial system to the coronary arteries. Contrast dye is injected through the catheter to visualize the coronary arteries on X-ray images.

Purpose:

Angiography is used to assess the presence and severity of coronary artery disease (blockages or narrowing in the arteries supplying blood to the heart muscle) and to identify the location and extent of any blockages.

Performed by:

An interventional cardiologist typically performs coronary angiography in a catheterization lab (cath lab) equipped with specialized imaging equipment.

Placing Stents (Angioplasty with Stent Placement):

Procedure:

If significant blockages are identified during angiography, the interventional cardiologist may perform angioplasty (also called percutaneous coronary intervention or PCI) to widen the narrowed or blocked artery. This is often done by inflating a balloon at the tip of the catheter to compress the plaque and restore blood flow. Additionally, a stent—a small mesh tube—is often placed in the artery to keep it open and prevent re-narrowing.

Types of Stents:

Stents can be either bare-metal stents (BMS) or drug-eluting stents (DES), which are coated with medication to reduce the risk of restenosis (re-narrowing).

Selection of Stents:

The choice between BMS and DES depends on various factors, including the patient's medical history, the complexity of the lesion, and the risk of restenosis.

Performed by:

The placement of stents is also performed by the interventional cardiologist during the same procedure as the angiogram. After the artery is widened with angioplasty, the stent is inserted and deployed at the site of the blockage.