Angiogram vs angioplasty, what’s the difference?

What is a coronary angiogram?

A coronary angiogram, also known as coronary angiography, is a diagnostic test used to look at the arteries that supply blood to your heart. It uses X-ray imaging and a special contrast dye to identify any narrowing or blockages in the coronary arteries.

During the procedure, a thin tube called a catheter is inserted through an artery in the wrist or groin and guided to the heart with the use of an x-ray guidance system to help the cardiologist navigate the catheter. The dye is injected into the coronary arteries, and X-ray images are taken to show whether there are any narrowings within the coronary arteries and how well blood is flowing to the heart. The procedure is performed under local anaesthetic, usually takes 30-60 minutes, and is typically carried out as a day-case.

An angiogram is a diagnostic procedure, meaning it helps identify a problem rather than treat it. If a blockage is found, your cardiologist may recommend treatment such as an angioplasty.

What is coronary angioplasty?

Coronary angioplasty, which is also known as percutaneous coronary intervention (PCI), is a treatment used to open narrowed or blocked coronary arteries and improve blood flow to the heart. Depending on the nature of the narrowing, a PCI procedure can follow-on immediately after a coronary angiogram or occur on a separate occasion.

The procedure is performed using the same approach as an angiogram, with a thin catheter inserted through an artery in the wrist or groin. Once the blockage has been located, a small balloon is inflated to widen the artery. In most cases, a stent (a small mesh tube) is placed to help keep the artery open and reduce the risk of it narrowing again.

Angioplasty is usually carried out under local anaesthetic and typically takes one to two hours. Unlike an angiogram, which is used to diagnose a problem, a PCI or angioplasty is a procedure to treat coronary artery narrowings, designed to improve blood flow and help relieve symptoms such as angina (chest pain).

What is the difference between an angiogram and angioplasty?

While an angiogram and angioplasty are often discussed together, they have different purposes. Put simply, an angiogram finds the problem, while an angioplasty treats it.

Angiogram vs Angioplasty: key differences

Angiogram

• A diagnostic procedure used to assess the coronary arteries
• Uses X-ray imaging and contrast dye to identify narrowed or blocked arteries
• Performed under local anaesthetic
• Typically takes 30-60 minutes as a day-case procedure
• Always performed before angioplasty

Angioplasty

• A procedure used to open narrowed or blocked coronary arteries
• Uses devices including balloons to widen the artery, often followed by implantation of a stent to help keep it open
• Aims to improve blood flow to the heart and relieve symptoms
• Performed under local anaesthetic
• Typically takes 1-2 hours as a day-case procedure
• May be performed immediately after an angiogram if a significant blockage is found

Can an angiogram and angioplasty be done at the same time?

Yes. If an angiogram shows a narrowing or blockage that needs treatment, your cardiologist may be able to carry out an angioplasty during the same procedure, rather than arranging a separate appointment. This approach is known as an ad hoc angioplasty or same-sitting angioplasty.

This depends on factors such as the location and complexity of the blockage, as well as your overall health. Your cardiologist will always discuss the most suitable treatment with you.

What about angiography vs angioplasty?

Angiography is the name of the procedure that uses X-rays and contrast dye to look at the coronary arteries, while an angiogram is the image produced during that procedure. In practice, both terms are used interchangeably. Both refer to the test to identify a blockage, while angioplasty is the treatment used to open it.

What are the risks and side effects of an angiogram and angioplasty?

Angiograms and angioplasty procedures are routinely performed and are generally considered safe. However, as with any medical procedure, there are some risks and potential side effects to be aware of.

Angiogram risk and side effects

Most people experience no serious complications following an angiogram. The most common side effects are mild and temporary, including:

• Bruising, tenderness or minor bleeding where the catheter was inserted
• Mild discomfort at the wrist or groin
• Temporary flushing or a warm sensation when the contrast dye is injected

Less common risks include:

• An allergic reaction to the contrast dye
• Infection at the catheter insertion site
• Damage to the blood vessel
• Changes in kidney function caused by the contrast dye
• Rare complications such as a heart attack or stroke (less than 1% risk)

Angioplasty risk and side effects

Angioplasty carries many of the same risks as an angiogram, as well as some additional risks associated with treating the artery and placing a stent.

Potential risks include:

• Bruising, bleeding or discomfort at the catheter insertion site
• Allergic reaction to the contrast dye
• Temporary changes in kidney function
• Damage to the artery being treated
• Blood clots forming within a stent (stent thrombosis)
• The artery narrowing again over time (restenosis)
• Rare complications such as a heart attack, stroke or emergency surgery (less than 1% risk)

While these complications can occur, they are uncommon, and your cardiologist will discuss the risks and benefits of treatment with you before the procedure.

What happens after an angiogram or angioplasty?

Recovery is usually straightforward after both procedures, although the recovery period is generally longer following an angioplasty than an angiogram alone.

After an angiogram most patients can go home the same day after a short period of monitoring. You may have some mild bruising or soreness at the catheter insertion site, which should improve within a few days.

Your cardiologist will explain the results of the angiogram and discuss whether any further treatment is needed. Most people can return to light everyday activities within 24 hours, although you may be advised to avoid heavy lifting or strenuous exercise for a short period.

After coronary angioplasty many patients are also able to go home on the same day, although some may stay overnight for observation depending on their individual circumstances.

If a stent has been inserted, you'll be prescribed medications to help prevent blood clots from forming inside it. This usually includes aspirin together with another antiplatelet medication, such as clopidogrel, for a period recommended by your cardiologist, often at least 12 months.

You may need to avoid strenuous activity for several days while the insertion site heals. Your care team will arrange any necessary follow-up appointments and provide advice on medication, exercise and lifestyle changes to help support your long-term heart health.