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What is a Coronary Catheterization?

By G.W. Poulos
Updated May 17, 2024
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Coronary catheterization is a medical procedure in which a thin, flexible tube is inserted into a patient’s arterial system, usually though the femoral artery at the upper thigh. The tube, or catheter, is then fed through the arteries to the patient’s coronary system, which consists of the arteries and veins responsible for blood flow to and from the heart. Once they have inserted the tube in the coronary system, physicians can use it to perform various tests and treatment procedures.

The most common purpose for a coronary catheterization is to evaluate a patient’s coronary system for obstructions cause by a buildup of plaque along the walls of the various blood vessels. In this procedure, a patient lies on a flat table, and the physician feeds the catheter to the heart, where a dye is injected into the bloodstream. As the dye circulates with the blood, the doctor can observe the flow on an x-ray machine to see anywhere the vessels might be narrowing due to plaque build-up. This same procedure can also be used to evaluate other conditions related to the heart, such as valve function, the size of heart chambers, and efficiency with which the muscles of the heart’s chambers contract and relax.

In addition to injecting dye into the coronary system to observe its function, doctors can perform a series of other tests during a coronary catheterization. The tests include the ability to monitor blood pressure and flow within certain arteries or chambers of the heart. They can also be used to measure the pressure of the blood flowing to and from the lungs, which cannot be measured separately from outside the body.

The tube used in a coronary catheterization can also be used to perform certain procedures. Stents, small metal or plastic tubes, can be inserted into blocked or partially blocked blood vessels to restore blood flow. Small balloons can be inserted through the catheter, inflated within a blood vessel, and then deflated, increasing the diameter of a blocked or partially blocked vessel in a procedure known as angioplasty. Another procedure that can be performed through a catheter is an atherectomy. In this procedure, a clot or other obstruction is located, and then a small blade or laser is inserted through the catheter to destroy the blockage.

As technology has advanced, the use and versatility of coronary catheterization have increased. Different and improved types of cutting devices, such as new types of lasers and rotary blades, have been designed to increase the efficiency and types of procedures that can be performed through a coronary catheter. There have also been advances in using devices such as stents covered with a layer of material containing drugs that can prevent or lessen negative reactions within the body, increasing the life of the stent and reducing the need for further invasive procedures.

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