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Coronary Angiography is the most accurate method (the "gold standard") for evaluating and defining coronary artery disease (CAD). Coronary angiography is used to identify the exact location and severity of CAD.

Coronary angiography is a test that uses dye and special x rays to show the insides of your coronary arteries. The coronary arteries supply oxygen-rich blood to your heart. A waxy substance called plaque can build up inside the coronary arteries.

The Surgery
During coronary angiography, a small catheter (a thin hollow tube with a diameter of 2-3 mm) is inserted through the skin into an artery in the groin or the arm. Guided with the assistance of a fluoroscope (a special x-ray viewing instrument), the catheter is then advanced to the opening of the coronary arteries, the blood vessels supplying blood to the heart. Next, a small amount of radiographic contrast (solution containing iodine, which is easily visualized with x-ray images) is injected into each coronary artery. The images that are produced are called the angiogram. Angiographic images accurately reveal the extent and severity of all coronary arterial blockages.

Coronary angiography is performed with the use of local anesthesia and intravenous sedation, and is generally not terribly uncomfortable. The procedure takes approximately 20-30 minutes. After the procedure, the catheter is removed and the artery in the leg or arm is sutured, "sealed," or treated with manual compression to prevent bleeding.

Risks:
There is a small risk of serious complications from coronary angiography, as it is an "invasive" test, but in the hands of an experienced physician, this risk is quite small (well below one per cent).
Because angiography involves puncturing an artery, internal bleeding or hemorrhage are possible complications of the test.

• There is always a slight chance of cancer from radiation. However, the benefit of an accurate diagnosis far outweighs the risk.
• Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant.
• If you have diabetes or kidney disease, the kidneys may be injured when contrast material is eliminated through the urine.
• The catheter may damage a coronary artery. If this occurs, the artery may be repaired by emergency heart surgery.
• A stroke.