Single Plane & Bi-Plane Angiography
Angiography System is useful and essential for diagnostic and intervention
vascular/non-vascular procedures. Besides the existing Single Plane Angiography
System, as the huge increment of today's demands for more diagnostic and interventional
imaging, this has resulted in the need for our hospital to add another cath lab to our
facilities.
To date, the two cath lab angiography machines - Toshiba Single Plane Angiography System
and the new GE Bi-Plane Angiography System, which commissioned in February 2001, are used in
diagnostic and intervention vascular/non-vascular procedures in Penang Adventist Hospital.
By March 3, 2003, the total figure of Single Plane Angiography cases done is 5579 (since
1990); and the total figure of Bi-Plane Angiography cases done is 2521 (since 2001).
The role of Angiography machine
These facilities are the gold standard for cardiac diagnosis, where doctors are able to
easily view inside a blood vessel under x-ray guidance using a contrast medium to fill the
vessel. Any narrowing of the vessel can then be noted and recorded. In the non-vascular
procedures, any organ of the body is accessible with the help of fluoroscopy. Such detail
diagnostic image and information is very useful for accurate diagnostic and interventional
procedures, and further case treatments.
Toshiba Single Plane Angiography System
It is the first Cardio-Vascular Angiography Lab in Penang, which is operational since
October 1990. It is than upgraded to digital system in 2001, with its image intensifier
upgraded from 9” to 14” to accommodate vascular & non-vascular procedures.
GE Biplane Angiography Equipment The newly installation of latest
General Electric Advantx LC/LP+, biplane angiography equipment, is able to
deliver high quality and low dose imaging for full range of diagnostic and
interventional procedures, including paediatric cardio angiography that
requiring a multi-axis biplane system.
This equipment with its latest technology is the first one installed in South East Asia.
It is fully DICOM compliant, filmless operation and able to archive images in a cost
effective and scaleable manner to meet the challenge of Cine replacement. This means we will
be able to transmit images via computers instead of looking at X-ray films. GE biplane
angiography equipment will be used for cardiac angiograms and other procedures.
Cardiac Catheterization
Arteries that supply your heart with blood are affected by 'atherosclerosis' or what is
commonly called 'hardening of the arteries'. The inner lining of the arteries gets
thickened and rough with deposits of cholesterol and other body fats. The narrowed arteries
allow less blood and less oxygen to reach the heart than is needed. When blood flow to the
heart muscle is less than the demand you may experience angina. If the blood flow to the
heart is totally blocked, a heart attack occurs.
An angiogram is a type of x-ray. A special type of a camera is used to look at the
arteries that feed your heart with blood.
An angiogram is used to find clogged or narrowed places along the coronary arteries. The
process of getting an angiogram is called Cardiac Catheterization.
Before the Catheterization
- You will need to give your consent to have this procedure
done by signing a special form.
- Blood will be taken for various tests that will be needed
to complete the tests.
- An ECG and a chest x-ray will be taken.
- You will be asked not to eat or drink anything after a light
breakfast or lunch, depending on the time of the procedure. This is
to prevent you from vomiting during the procedure.
- Both groins will be shaved and you will be required to have a bath
using a special solution 'hibiscrub'.
- A brannula will be inserted into a vein in one hand to give you fluids
and injections as needed.
- You will be asked to empty your bladder.
- You will be given medication to help you relax but not sleep during
the procedure.
The Cardiac Catheterization Laboratory is a specially equipped area where this procedure
can be done. Only you will be allowed inside, any relative or companion with you will be
asked to wait outside the lab during the procedure.
The Procedure
- You will lie on a hard table near the equipment that will be used to take the
special x-rays.
- Electrodes will be placed on your chest to monitor your heart during the
procedure.
- Your groin or arm will be cleaned and the doctor will give a small injection to
numb the area. An introducer be gently inserted into one artery either on your arm
or the groin. A thin plastic tube called catheter will then be inserted through the
introducer into the artery.
- A special dye will be injected into the catheter to make the arteries of the
heart show up more clearly on the x-ray.
- Several x-rays will be taken as the fluid goes in. You may be asked not to cough
or breathe for short periods.
- You will be asked to see the movement of your heart, the catheter inside you and
also the outline of your coronary arteries on the monitor if you like.
What Does It Feel Like?
Many of those who undergo this study do not feel pain during the test. Others may feel
the following:
- You will lie on a hard table near the equipment that will be used to take the
special x-rays.
- Electrodes will be placed on your chest to monitor your heart during the
procedure.
- Your groin or arm will be cleaned and the doctor will give a small injection to
numb the area. An introducer be gently inserted into one artery either on your arm
or the groin. A thin plastic tube called catheter will then be inserted through the
introducer into the artery.
- A special dye will be injected into the catheter to make the arteries of the
heart show up more clearly on the x-ray.
- Several x-rays will be taken as the fluid goes in. You may be asked not to cough
or breathe for short periods.
- You will be asked to see the movement of your heart, the catheter inside you and
also the outline of your coronary arteries on the monitor if you like.
These feelings are normal. However, be sure to let your doctor know if you feel any
severe discomfort during the test.
After the Catheterization
After the study is completed, the catheter and introducer will be taken out of the
artery.
- he doctor or nurse will apply pressure on the site for 10-15 minutes to
stop any bleeding.
- A small dressing will be applied over the puncture site and a sandbag
will be placed on it. This should remain in place for several hours.
- You will be asked not to move your affected limb for several hours.
- You will be kept in the recovery room for some time while the effect
of the medication given wears off.
- Your blood pressure and pulse will be checked frequently. The puncture
site will be observed to make sure there is no bleeding.
- You will need to drink a lot of fluids and have a light meal. The fluids
will help flush out the dye used for the procedure.
- Before you are allowed to leave, your doctor will check the puncture site and
also discuss the results of the procedure.
- You will be asked not to exert yourself or lift heavy objects for the
next 24 hours.
- Remember to drink plenty of fluids over the next 24 hours. This will help to
replace lost fluids and also flush out the dye.
Prepared by Tan Jui Kok
Radiology Department Manager.
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