Narrowing or occlusion of the coronary arteries, which carry blood to the heart and feed it, can cause a heart attack, which can lead to life-threatening conditions. Coronary artery disease, which is four times more common in men than in premenopausal women in the same age range; It manifests itself with symptoms such as chest pain, shortness of breath, dizziness and nausea.
Coronary vascular stenosis can be successfully treated with percutaneous intervention stent application from the wrist, without surgical procedure, thanks to current technological developments. The stent, which is inserted through the radial artery of the wrist, minimizes the rate of vascular complications and offers a comfortable treatment opportunity. Prof. from Memorial Service Hospital, Department of Cardiology and Interventional Cardiology. Dr. Uğur Coşkun gave information about coronary artery disease and modern treatment methods.
Men are 4 times more at risk than women
3 to 5 percent of the blood flow in the whole body passes through the coronary vessels. Coronary arteries are the first branches of the aorta, which is our main artery coming out of the heart after the aortic valves. These two coronary vascular systems, which are divided into right and left, constantly pump the blood needed by the body and continuously provide the circulation needed for its own nutrition to the working heart muscle. Coronary artery disease, on the other hand, occurs with the obstructions caused by the transport of cholesterol particles under the thin endothelial membrane layer that covers the lumen of these vessels. Coronary artery disease is usually seen after the age of 40. Coronary artery disease, which is four times more common in men in their 40s than in women, closes this difference after menopause, and even in their 60s the risk increases more in women. People with a family history of extensive coronary artery disease, familial hypercholesterolemia or other risk factors for atherosclerosis may also have this disease at a much earlier age.
Sedentary life can cause coronary artery occlusion
Coronary artery disease risk factors are divided into two groups as correctable and non-correctable. Hypertension, high cholesterol, a sedentary lifestyle, stress, and smoking and alcohol use are correctable risk factors. Genetic factors, advanced age and male gender are irreversible risk factors. In order to minimize the risk of coronary artery disease, it is necessary to exercise regularly, maintain a normal weight, live without stress, eat regularly, ideally control hypertension and avoid foods containing high cholesterol.
Nausea and tension in this area can be a sign of coronary artery disease
The most important symptom of coronary artery disease is chest pain. discomfort in the chest; It can also be defined as heaviness, tension, pressure, pain, burning, numbness, fullness or tightness. Other symptoms of coronary artery disease include:
- Shortness of breath
- Heart palpitations
- Pain and numbness in one arm, more often in both arms or left arm
- Tension, pain and burning sensation in the stomach area
- Nausea
- Feelings of extreme weakness and exhaustion
- cold cold sweat
Radial artery angiography from the wrist minimizes the risk of bleeding
Coronary artery occlusions are diagnosed with “ECG”, “Tread Mill Exercise”, “Echocardiography”, “Pharmacological Stress Echocardiography”, “Stress Nuclear Myocardial Scintigraphy”, “Multisection Computed Tomographic Coronary Angiographic” examinations. The gold standard for diagnosis is classical coronary angiography. Coronary angiography is most commonly performed from the femoral artery in the groin or from the radial artery in the wrist. With today's technological developments, coronary artery imaging from the radial artery in the wrist, which minimizes the patient comfort and the risk of bleeding complications, comes to the fore. Coronary artery occlusions detected by this method can be treated with balloon and coronary stent in the same session.
Advantages of radial artery angiography at the wrist
The radial artery from the wrist increases patient comfort by minimizing the risk of bleeding. The advantages of angiography performed through the radial artery of the wrist, which is used by an experienced team in diagnostic and interventional coronary vascular procedures, are as follows:
- Since the radial artery is just above the Radius bone in the wrist, bleeding control at the entry site can be achieved even with a simple finger pressure.
- Arterial complications are less common.
- Sandbags or other materials used to close the inguinal vein are not needed.
- After angiography, patients can walk and urinate.
- The patient can be discharged 3-4 hours after the procedure.
- It is preferred in patients with advanced folds and occlusion in the leg veins.
- Since inguinal interventions are more risky in obesity patients, wrist angiography greatly reduces these risks.
- A stent can also be inserted from the radial artery, so the complication rates such as bleeding are much lower than in patients with a stent from the groin.
Things to consider about radial angiography
Since the arm vein is a thin vein compared to the inguinal vein, it can cause painful spasms that prevent the passage of catheters, especially in women with short stature, thin wrists, and diabetics.
The angiography time is 5-10 minutes longer than the inguinal one. (Because it requires preliminary preparation, it depends on more attention and experience, it may need more manipulation to settle in the coronary vessel in the aorta)
The radiation time and dose taken in the angiography may be higher accordingly.
Reaching the bypass vessels and inserting the catheter in patients with bypass may be a little more difficult and requires experience.
This process should be done by experts experienced in this field in fully equipped centers.
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