Angiography in Iran

When is angiography performed?

If you have any of the following symptoms, you will probably need to have an angiogram:

• 1- Symptoms of vascular disease such as chest pain (angina)
• 2- Pain in the chest, jaw, neck or arm, not diagnosable by other tests.
• 3- Recent feeling of pain in your chest or aggravated pain over time. (Unstable angina)
• 4- Congenital heart disease
• 5- Abnormal results in cardiac tests
• 6- Other blood vessel problems or chest injuries
• 7- Conditions of the heart valve that requires surgery.

Angiography is a relatively low-risk procedure, so it is of higher priority in comparison to other heart-related tests such as electrocardiograms or echocardiograms.

Possible Risks of Angiography

As with most procedures on the heart and blood vessels, angiography may also pose risks, such as exposure to X-ray radiation used in angiography. Although complications of this process are often rare, they can still occur. Possible risks and complications include:

• 1- Heart attack
• 2- Stroke
• 3- Damage to the catheterized artery
• 4- Irregular heart rhythm (arrhythmia)
• 5- Allergic reactions to dyes or medications that will be used during angiography.
• 6- Kidney damage
• 7- Excessive bleeding
• 8- Infection

Preparations for Angiography

In some cases, angiography is performed urgently. Usually, though, this process is pre-scheduled and the treatment staff will give you time to prepare. Angiography is performed in the hospital’s catheterization laboratory.

The health care team will explain how it works. They will also explain the medications you will be taking after the angiography and there is no need to worry. Some steps before angiography include:

• 1- Do not eat or drink anything from the night before angiography.
• 2- Explain in full detail about all the medications you are currently taking to your doctor and also ask questions about how to take the next medications.
• 3- If you have diabetes, ask your doctor if you should take insulin or other oral medications before angiography.

During angiography

Before starting the angiography procedure, your healthcare team will review your medical history, including allergies and medications you are taking. The team may perform a thorough physical exam to check for your vital signs such as high blood pressure and pulse. Empty your bladder and wear hospital gowns before having an angiography. You may need to remove contact lenses, glasses, jewelry, and hairpins for angiography.

You will lie on your back on the X-ray table. Since the table may tilt during angiography, safety straps may be fastened on your chest and legs. X-ray cameras move around your head and chest to take pictures from different angles. An IV is inserted into the vein of your arm. It may be injected through the (IV), sedatives as well as other medications needed to help you stay calm. You will be anesthetized for angiography, but you will easily regain consciousness and have a high level of consciousness after the procedure.

Electrodes on the chest monitor the heart at all stages. A blood pressure cuff measures your blood pressure at all times. Another device called a pulse oximeter measures the amount of oxygen in the blood. Where a flexible hinge called a catheter will be inserted, some of your thigh or arm hair may need to be shaved. The area will be washed and then disinfected and anesthetic will be injected into the area. A small incision is made at the entrance and a short plastic tube (sheath) is inserted into your artery. The catheter is inserted through a sheath into a blood vessel and carefully attached to the heart or arteries.

Inserting the catheter should not cause pain and you should not feel the counter move in the body. Notify your health care team if you have any discomfort. The dye or contrast material is injected through the catheter. When this happens, you may feel hot flashes and warmth. But if you feel pain or discomfort, tell your health care team. The color is easily visible in X-ray images.

As the injected dye moves through your blood vessels, your doctor can observe the dye flow and identify any blockages or contracted areas. Depending on what your doctor notices during your angiography, you may simultaneously undergo additional catheter procedures such as balloon angioplasty or stent placement to open a narrow vein. Other required tests, such as an ultrasound, may help your doctor evaluate the identified obstruction. Angiography takes about an hour. Although it may be longer. Especially if combined with other methods of cardiac catheterization. Preparation and post-operative care can add more time to this time.

After Angiography

When the angiography is complete, the catheter is removed from the arm or groin and the incision is closed with manual pressure, a clip, or a small plug.

After the angiography, your condition will be checked by a doctor. If you are in good condition, you will be transferred to your own room and then rest until your recovery period is over.

To avoid possible bleeding after the counter is removed from your groin, you need to lie down for several hours. Squeeze the wound to be more secure and to prevent bleeding.

You may be discharged from the hospital on the first day or you may have to spend a night in the hospital.

Drink a lot of fluids to excrete the dye that was injected into your body. Otherwise, eat water-rich foods. Ask your doctor how you should take your medication, or when you can resume your daily activities such as showering or exercising. You need to avoid strenuous activities for a few days. Your incision may be slightly bruised or may be more prominent than before.

Symptoms that Require Immediate Attention after Angiography

If you experience any of the following conditions, call your doctor immediately. Conditions including:

1- Bleeding, bruising or new swelling at the incision site.

2- Unbearable pain or discomfort at the catheter site.

3- Symptoms of infection such as redness or fever.

4- A change in temperature or the color of the foot or arm.

5. Weakness or numbness in your leg or arm where the catheter is placed.
6. Chest pain or shortness of breath.

If the incision site is bleeding regularly and does not stop by putting pressure on the wound site or if the incision site suddenly swells, call the emergency immediately and ask for help.

Angiography Result

Angiography can show doctors what is wrong with your blood vessels. Angiography can also help you identify the following:

1. How many of your coronary arteries are blocked or narrowed by fatty plaques. (Atherosclerosis)
2. The location of the blockage in the blood vessels
3. Whether blood flow is blocked through your blood vessels.

Knowing this information can help your doctor determine what the best treatment for you is and how threatening is the heart disease to your health. Based on the angiographic results, for example, your doctor may decide that you can use coronary angioplasty or stents to help clear blocked blood vessels.

Angiography Post-Operative Instructions

After angiography, your doctor will give you the necessary explanations. But most of the time there are a set of fixed instructions. These guidelines include:

1- Try to rest as much as you can.

2- Avoid standing for more than a few minutes at a time.

3- Avoid lifting weights for at least a week after surgery.

4- Visit a doctor if you suspect an infection.

5- Drink plenty of fluids eight hours after surgery (unless your cardiologist says otherwise) to remove the injected dye.

Types of Angiography

There are different types of angiography, depending on which part of the body is being observed. Common types of angiography include:

• Coronary angiography: to examine the heart and blood vessels
• Cerebral angiography: examination of blood vessels in and around the brain
• Pulmonary angiography
• Renal angiography: examination of blood vessels in the kidneys

Cerebral Angiography

Cerebral angiography is a diagnostic test in which X-rays are used. Cerebral angiography creates an image that can help your doctor diagnose blockages or other abnormalities in the blood vessels in your head and neck. Occlusion or abnormality can lead to a stroke or bleeding in the brain. Not everyone who may have an arterial blockage needs a cerebral angiogram.

Cerebral angiography is usually done only if your doctor needs more information. Brain angiography carries many risks. Angiography can also be used to treat some diseases of the blood vessels in the neck and brain. Cerebral angiography can help diagnose the following:

• 1- Aneurysm
• 2- Atherosclerosis
• 3- Arterial Malformations
• 4- Vasculitis or inflammation of blood vessels
• 5- Brain Tumors
• 6- Blood clotting

Cerebral angiography may also help your doctor diagnose the cause of some conditions, including:

• 1- Stroke
• 2- Severe headaches
• 3- Memory loss
• 4- Stuttering
• 5- Dizziness
• 6- Blurred vision
• 7- Loss of balance

Renal Angiography

Renal angiography is a kidney imaging test to examine blood vessels in the kidneys. Your doctor can use it to check for the ballooning of a blood vessel (aneurysm), narrowing of a blood vessel (stenosis) or blood vessel blockages. Your doctor will also check the quality of blood flow in your blood vessels.

Angiography in Iran and the Best Angiography Specialists in Iran

More than 35,000 Iranian and foreign patients undergo angiography in Iranian hospitals every year. Iran is one of the top countries in the Middle East in terms of skilled specialists and surgeons.

The Cost of Angiography in Iran

There is a significant difference between the cost of angiography in Iran and other countries. The most important factors in the low cost of angiography in Iran are:

1- A large number of angiography centers in Iran.

2- A large number of angiography applicants in Iran.

The cost of angiography in Iran varies depending on the type of angiography and hospital. The average cost of angiography in Iran is $4,000. More than 70,000 cardiac surgeries are performed each year in Iran. Experienced Iranian physicians perform these operations with excellent experience. Many patients travel to Iran for angiography. One of the reasons for this is Iranian specialists and surgeons with high surgical success. Other factors include:

• 1- Low cost of angiography in Iran
• 2- Low cost of accommodation in Iran
• 3- Experienced physicians
• High number of angiography in Iran

Iranian hospitals perform the highest quality of surgery in Iran in accordance with modern European standards.