Coronary angiography and coronary CTA, which is better?
Source | Heart Health
Mrs. Liu went to the hospital because of the recent chest discomfort, the result of the two cardiology number, a doctor suggested Ms. Liu to do coronary angiography, while another doctor suggested Ms. Liu to do coronary CTA. this terrible Ms. Liu worried about the background message to me, asked me in the end is to do the angiography or to do the CTA, today we will come together to The first thing you need to do is to get a good idea of what you're looking for, and what you're looking for.
Coronary CTA and coronary angiography are important means of evaluating the presence of lesions in the coronary arteries as well as guiding the treatment of the two have their own advantages and disadvantages, and each has its own advantages and disadvantages, in different cases to choose a different way of checking the need to decide on the basis of the situation, can not be set in stone that the coronary artery CTA is good or coronary angiography is better. It is necessary to analyze specific problems.
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Coronary CTA
■Coronary CTA what?
Coronary CTA is a non-invasive examination of the coronary arteries, the main principle of the examination is to use a high-pressure syringe in the coronary arteries will be rapidly injected into the coronary arteries, and then the use of CT rapid multilayer scanning and image reconstruction technology, to generate coronary artery images of a technology, can be a basic understanding of coronary artery lesions and the degree of stenosis.
■What are the advantages of coronary CTA?
1. Non-invasive: Coronary CTA is a "non-invasive, fast, accurate" means of coronary heart disease screening, and has become a boon to many patients who need to know the condition of the coronary arteries. The biggest advantage of cardiac CT is that it is non-invasive compared to interventional coronary angiography.
2. Better plaque assessment: In addition to being non-invasive, cardiac CT also has advantages over coronary angiography in measuring calcified plaque load, understanding the coronary wall and extracoronary conditions, and detecting congenital coronary artery developmental abnormalities.
3. Less risky: Coronary CTA is less risky than coronary angiography because it is non-invasive and non-invasive.
4. Lower cost: Coronary CTA is much cheaper than coronary angiography and is safer with fewer side effects.
■What are the disadvantages of coronary CTA?
1. The images are static, which is worse than coronary angiography for evaluating blood vessel conditions;
2. The requirements for heart rate and operation reconstruction are higher;
3. It is more affected by vascular calcification;
4. Because of the static images, it is not possible to evaluate blood flow and its direction of flow.
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Coronary angiography
■What is coronary angiography?
Coronary angiography is a common test used to check for normal blood vessels in the coronary arteries. It is an invasive procedure that involves sending a contrast catheter through the peripheral arteries to the ascending aorta and then to the opening of the coronary artery, where it is pushed to inject a contrast medium to visualize the coronary arteries. Coronary angiography is also known as the "gold standard" for diagnosing coronary artery disease.
■What are the advantages of coronary angiography?
1. Dynamic multi-angle display of blood vessels, more accurate assessment of lesions, but also to provide more accurate guidance on treatment.
2. Lower requirements for heart rate and other conditions make imaging suitable for a wider range of people.
3. Direct interventional therapy is possible, which makes it safer and more effective to examine and treat at the same time.
4. Less affected by vascular calcification, etc., it can better determine the direction of blood flow and blood flow.
■What are the disadvantages of coronary angiography?
1. Invasive: Patients may be more uncomfortable because of the invasive nature of the procedure, which involves inserting an imaging catheter into the opening of a coronary artery.
2. More risky: Because it is invasive, it is riskier and can have more complications.
3. Higher cost: Compared with coronary CTA, it is more expensive.
4. Does not reflect the condition of the vessel wall and plaque: compared with coronary CTA, the condition of the vessel wall is not as good as that shown by CT.
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Whether to do CT or imaging?
1. Imaging is preferred in patients with a clear cause of discomfort due to coronary artery disease, whereas CTA is preferred in patients with unexplained chest discomfort.
2. CTA is preferred in cases where coronary assessment is required for proposed surgical procedures.
3. Imaging is preferred in cases where coronary interventions or coronary surgery is proposed.
4.
4. Coronary angiography is preferred in cases of clinically confirmed or highly suspected coronary artery disease.
5. CTA is preferred for assessment of the bridge vessel in bypass patients.
6. Imaging is preferred for assessment of the effect of intervention or stenting, and after thrombolysis.
In fact, after so many descriptions, it is very simple to say that imaging is preferred for patients who have further treatment as well as for those who have a clear pre-existing condition. Secondly, CT may be preferred for evaluation.
And the easiest way is actually to follow the doctor's instructions. Because doctors need to understand your situation in different dimensions, they need to make different tests, and sometimes, we need to do both coronary CTA and imaging to better determine what to do next?
As for Ms. Liu, some suggested CT and some suggested imaging, it should be that the physician who suggested CT was more inclined to think that Ms. Liu did not look like a coronary artery disease, while the physician who suggested imaging might be more inclined to think that Ms. Liu was a coronary artery disease with a higher likelihood of being a coronary artery disease only.