Diagnostic imaging during procedures

Fluoroscopy: The Moving X-Ray

The workhorse of every procedure is fluoroscopy, a continuous, real-time X-ray that displays live moving pictures on large screens above the table. As we guide a catheter from your wrist or leg up to your heart, fluoroscopy shows us its position every moment of the journey. Think of it as GPS for the heart: we always know exactly where we are.

Angiography: Lighting Up the Arteries

Blood vessels are invisible on a plain X-ray, so we make them visible. By injecting a contrast dye through the catheter, the arteries suddenly light up on screen like a road map. This is angiography, and it shows us precisely where blood flows freely and where a blockage narrows the road. Every angioplasty, every stent, every heart attack rescue begins with this map. You may feel a brief warm sensation when the dye goes in, that's normal, and it passes in seconds.

Ultrasound From the Inside

Sometimes we need more than a road map, we need to see the road surface itself. Intravascular ultrasound, or IVUS, places a tiny ultrasound probe on the tip of the catheter, giving us a view from inside the artery. We can measure the vessel precisely, study the plaque, and confirm that a stent is fully expanded against the wall. When a stent fits perfectly, it lasts, and IVUS helps us get it right the first time.

Pressure Measurements: Is the Blockage Truly Significant?

Not every narrowing needs a stent. Using a fine pressure wire, we can measure blood pressure on both sides of a blockage. If the pressure drop is small, the blockage isn't starving the heart, and medication may be the wiser path. This measurement, called FFR, helps us stent what matters and leave alone what doesn't. Good judgment, guided by good data.

Echocardiography: Sound Pictures of the Heart

During structural procedures such as valve replacement or closing holes in the heart, we add echocardiography, detailed ultrasound of the heart itself, sometimes from a small probe positioned nearby. It shows the valves opening and closing, blood flowing chamber to chamber, and our devices seating exactly where they belong, in real time.