Talk:Coronary catheterization

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Complication Rate[edit]

I am not a doctor. I don't even play one on TV.

The article on Coronary catheterization states "significant complication rates typically in the less than 0.0003% range". This is orders of magnitude lower than other figures I've seen (Noto, TJ, Johnson, LW, Krone, R, et al. Cardiac catheterization 1990: A report of the registry of the Society for Cardiac Angiography and Interventions. Cathet Cardiovasc Diagn 1991; 24:75.). Which states "the mortality for diagnostic procedures has remained remarkably constant (0.11%)". I don't know what could be more significant than mortality.

I'm not familiar with Wikipedia's policies, but citing sources would seem the norm. I don't know if I can believe one word in the article.

Most of the article is correct. The question is which part. If you come accross unreliable or poorly cited information, just add {{fact}} as a faux reference. Other readers will understand there is no source yet, and will take the statement with the proverbial grain of salt. WP:CITE is indeed a key Wikipedia policy. JFW | T@lk 22:08, 13 March 2006 (UTC)[reply]

The above comment is correct, 0.1% is the rate quoted to patients at the time of consent for cath. Mortality today continues to be about 0.1%, and the other complications are higher. There should be a detailed discussion of the complications: not limited to dissection, MI, Death, stroke, urgent CABG, groin hematoma, hemorrhage, etc. Dlodge 00:10, 11 December 2006 (UTC)[reply]

Unnecessecary limited article[edit]

Why only coronary catheterization? We do alot of procedures for other reasons! --Ekko 19:00, 7 October 2005 (UTC)[reply]

This is an extremely common procedure and it definitely deserves an article on its own. JFW | T@lk 22:06, 13 March 2006 (UTC)[reply]

History[edit]

In the history section, mention was made on a physician performing an angiogram on himself. I could find no source for this assertion, and other historical articles simply provide a more convincing narrative. JFW | T@lk 22:06, 13 March 2006 (UTC)[reply]

This is correct. The first heart cath was performed by a German who threaded a catheter into his own heart and walked up the stairs to the x-ray dept. and shot film of the catheter in place. Dlodge 00:12, 11 December 2006 (UTC)[reply]

And of course, we even have an article on him: Werner Forssmann --WS 13:02, 11 December 2006 (UTC)[reply]

...which has a reference that says Forssman walked downstairs with 30 cm of catheter already in his arm, and then stood in front of a fluoroscope, saw (via a mirror) that the cath was at his shoulder as he expected, pushed it the full 60 cm in, and only then saw that the cath was now in his right ventricle. Then they exposed film. (I am relying on the cited reference; perhaps in Forssmann's original 1929 German report he says he walked upstairs... end of nitpick)LM6407 (talk) 06:39, 19 May 2012 (UTC)[reply]

The article begins by naming Antonio Egas Moniz as the first to perform angiography, in 1927. According to the eponymous article, that is true, but the only angiographic work cited in that article is cerebral angiography, for which Egas Moniz was nominated twice for a Nobel Prize but did not win. Since the Nobel Prize for Physiology or Medicine was awarded in 1956 jointly to Forssman, Cournand, and Richards for their development of coronary angiography, if Egas Moniz had preceded those winners in developing coronary angiography even in the least, it is hard to believe that the Nobel Committee would have ignored him in 1956. Egas Moniz is properly credited in Wikipedia with cerebral angiography, but he deserves no more than that. I have so edited the article.LM6407 (talk) 05:43, 19 May 2012 (UTC)[reply]

I further edited the article by removing a paragraph that had an inline, non-footnoted reference about a minor development in 1953 which was claimed to be a "first". Given the extensive work being done in multiple sites in Switzerland and in the USA during and after World War II, it is likely that others deserve the claimed credit for lighting up the left coronary arteries nonspecifically from the aorta. (See the Forssman article referenced above, which reports on his visit to a cath lab in Zurich in or before 1951. Nonspecific angiography was all that was being done at that time.)LM6407 (talk) 06:19, 19 May 2012 (UTC)[reply]

I lastly copied over the paragraph from History of Invasive and Interventional Cardiology re the Nobel Prize for Forstmann, Cournand, and Richards that really belongs in this article as long as it stands alone. There certainly is multiple overlapping content in this topic area. IMHO the most complete article is History of Invasive and Interventional Cardiology; the rest of these similar topics should be merged into that article, which could then get a new title.LM6407 (talk) 06:39, 19 May 2012 (UTC)[reply]

More specificity and possible merge[edit]

I would be interested in seeing a better description of the diagnostic aspects, particularly the distinction between a right heart cath and a left heart cath plus the left ventriculogram. Also, there is short wiki page for cardiac catheterization which could either be merged or redirected to this one as this one is much more extensive (though I've always heard it called a cardiac cath which is why I found that page first).--209.7.195.158 15:33, 17 May 2006 (UTC)[reply]

I agree. It doesn't make much sense that the owerview article cardiac catheterization is so much shorter than this, about a much more limited field. I suspect an age bias, and a volume bias. (Coronary cathetherization is done in a great volume on the middle aged.) --Ekko 13:35, 11 December 2006 (UTC)[reply]

History: Role of Melvin Paul Judkins[edit]

Needs mention of the role of Melvin Paul Judkins. [1] -- Fyslee (talk) 06:23, 7 April 2009 (UTC)[reply]

Coronary angiography vs. coronary catheterization[edit]

I am not a doctor, but I believe that the term "coronary catheterization" is broader than "coronary angiography". However, the term "coronary angiography" is redirected to this page. The term "coronary angiography" is not even mentioned in this article, or even "angiography". Something is wrong here. Thomas.Hedden (talk) 20:39, 31 May 2009 (UTC)[reply]

The picture is of a coronary angiogram and it is mentioned again in the diagnostic procedures section. The truth is that these procedures are called by many different terms, Cath, cardiac cath, angiogram, angiography, PCI, PTCA and others. Also many times the exact procedure that is going to be done isn't known till it starts. It may start as an angiogram but end up as an intervention or vice-versa. Dan D. Ric (talk) 20:52, 31 May 2009 (UTC)[reply]

Article by Willis is about leg arteries not heart[edit]

The paper quoted is about leg (femoral) arteries and not heart (coronary) arteries. "To overcome these difficulties it was decided to study the femoral and popliteal arteries by serial arteriography."

Results did not conclude Vitamin C cured lesions in arteries. Once again it must be pointed out that the series is small and that final conclusions must await studies carried out for a longer time with more cases added. This is being done, and the present review is to be considered as a preliminary report".

[2] — Preceding unsigned comment added by Carnifex2000 (talk • contribs) 10:37, 27 January 2011 (UTC)[reply]

Alternative approaches[edit]

I changed the name of the "Advantages and disadvantages" section, only because as it stood the focus was not on catheterization's advantages and disadvantages per so (although it mentions some), but rather on CT angiography as an alternative. I also made some stylistic mods, only because I suspect the original author wasn't native English-speaking and some of what was there wasn't idiomatic.

I have, however, tried to leave the meaning unchanged, because I'm not a specialist in this field (or even a medic). So it would be good if that original author -- or anyone else of enough experience -- would give my changes a once-over to make sure I haven't inadvertently changed some meaning. 70.114.180.201 (talk) 18:24, 26 August 2013 (UTC)[reply]

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Overlapping articles?[edit]

"Cardiac catheterization" is an article. But "Cardiac Catheterization" redirects to Coronary catheterization. David notMD (talk) 12:31, 9 November 2017 (UTC)[reply]

Done - thanks --Iztwoz (talk) 17:04, 9 November 2017 (UTC)[reply]

Merge Angiocardiography into coronary catheterization[edit]

Angiocardiography is essentially the same thing as "coronary catheterization" and I'm not sure there's much utility in maintaining a stub at angiocardiography. Cburnett (talk) 04:25, 28 December 2018 (UTC)[reply]

Agreed. Though you could make the same case about Percutaneous coronary intervention and

Angioplasty.Ploversegg (talk) 21:33, 30 December 2018 (UTC)[reply]

I agree to merge angiocardiography into coronary catheterization. No point in having two articles on the same subject. Spyder212 (talk) 00:52, 9 June 2019 (UTC)[reply]

Merger complete. Klbrain (talk) 04:50, 11 January 2020 (UTC)[reply]

Radiation dose[edit]

I want to add a short section on the radiation dose to the patient, and to the operators, at some point. I have a fair sense of the numbers for diagnostic angiography - say 3msv to the patient with modern equipment, but interventional case is more complicated. Exposure to the operator appears to be about 4msv a year.Ploversegg (talk) 17:30, 30 December 2018 (UTC)[reply]

Did angiography case. Need 2nd section for interventional case. When I get time I'll figure that out.Ploversegg (talk) 22:29, 7 January 2019 (UTC)[reply]

Reworded the 1st sentence to make clear the risk being addressed. This new section overlaps with 'Diagnostic procedures' which also discusses minimizing the exposure time. --Wire723 (talk) 09:35, 8 January 2019 (UTC)[reply]

Thanks. Maybe, in retrospect, I should have just augmented that section. I was in the pattern of adding an extra section after doing Coronary calcium scan. Ploversegg (talk) 23:23, 8 January 2019 (UTC)[reply]