Am I awake during the procedure, and does it hurt?

You are usually awake. Because the wrist is numbed with local anaesthetic, most people do not feel significant pain. You may feel brief warmth when the dye is given, and brief chest pressure while the balloon is inflated.

Is a stent placed at every angiogram?

No. The angiogram is first a diagnostic test. A stent is placed only when a narrowing that needs treatment is found and stenting is suitable. For some patients medication or bypass surgery may be more appropriate; these options are explained to you separately.

What is a drug-coated balloon, and can it be used instead of a stent?

A drug-coated balloon is a balloon coated with medicine that leaves no permanent mesh in the artery. It can be used in some situations, such as renewed narrowing inside a stent; for renewed narrowing inside a drug-eluting stent, a new drug-eluting stent is usually preferred. Your doctor decides whether it suits you based on the angiogram findings.

Why is the procedure done through the wrist?

Current guidelines recommend the wrist as the standard route in suitable patients. After a procedure through the wrist you can usually get up quite soon. If the wrist artery is not suitable, the groin is used.

How long will I need to take my medicines after a stent?

Your doctor decides how long you need the anti-clotting medicines, based on the reason for the procedure and your personal bleeding risk. Do not stop them before that time without talking to your doctor.

In case of sudden chest pain, shortness of breath or fainting, call 112.

Angiography, balloon and stent through the wrist

The heart arteries are imaged using a thin catheter, usually passed through the artery at the wrist. If a narrowing that needs treatment is found, in suitable patients it can be opened with a balloon and a stent placed in the same session.

What is it?

The arteries that supply the heart muscle are called coronary arteries. Over time, plaque made of fat and calcium can build up in their walls. Plaque narrows the artery, and the heart muscle may not get enough blood, especially during exertion. This can cause symptoms such as chest pressure or pain and breathlessness. In coronary angiography (often simply called an angiogram) a thin catheter is advanced to the openings of the heart arteries. A dye that shows up on X-ray (contrast agent) is injected and the arteries are imaged. This shows where a narrowing is and how severe it is. Today the catheter is usually passed through the artery at the wrist (radial artery); if needed, the artery in the groin (femoral artery) is used. If the angiogram shows a narrowing that needs treatment, in suitable patients the artery can be opened in the same session. A small balloon is inflated at the narrowing, then a thin metal mesh tube called a stent is placed to keep the artery open. Today drug-eluting stents, which slowly release a medicine into the artery wall, are used in most cases. This procedure is called percutaneous coronary intervention (PCI), or angioplasty. In some patients the results are discussed separately and other options, such as bypass surgery or medication, are considered. Drug-coated balloon: in some situations a balloon coated with medicine can be used instead of a stent. The balloon is inflated at the narrowing, leaves the medicine in the artery wall and is then withdrawn, so no permanent mesh is left in the artery. This may be considered, for example, when an artery narrows again inside a previously placed stent; however, for renewed narrowing inside a drug-eluting stent, the current guideline prefers placing a new drug-eluting stent. Your doctor decides whether it is suitable based on the angiogram findings. Prof. Dr. Barış Kılıçaslan performs coronary angiography, balloon and stent procedures, including complex coronary interventions, in his clinical practice.

Who is it for?

Patients with symptoms such as chest pain or pressure on exertion, or breathlessness, whose tests suggest coronary artery disease
Patients whose symptoms continue despite medication and in whom opening the narrowing is being considered
Patients having a heart attack, in whom the procedure is done as an emergency
The decision is made together with your doctor, based on your symptoms, test results and general health

Before the procedure

Before the procedure you will have an examination, an ECG, blood tests and, if needed, tests such as echocardiography or an exercise test. Your kidney function is checked with a blood test, because the dye used in the procedure is cleared by the kidneys. Tell your doctor beforehand if you have ever had an allergy to contrast dye or anything else, or if you have kidney disease, diabetes or any chance of pregnancy. Your medications, especially blood thinners and diabetes medicines, are reviewed with your doctor before the procedure. Do not stop any medication on your own. You may be asked not to eat for a few hours beforehand.

How is it done?

Preparation and numbing: The wrist is cleaned and numbed with local anaesthetic. You are usually awake during the procedure.
Access: A thin sheath is placed in the artery at the wrist. If this artery is not suitable, the artery in the groin can be used.
Angiography: Under X-ray guidance the catheter is advanced to the openings of the heart arteries. Dye is injected and the arteries are filmed from different angles.
Balloon and stent (or drug-coated balloon): If there is a narrowing that needs treatment, a fine wire is passed across it. A balloon is advanced over the wire and inflated, and a stent is placed; in some situations a drug-coated balloon is used instead of a stent.
Check and closure: The result is checked with further images. The catheter is removed and a pressure band is placed on the wrist.

Recovery

After a procedure through the wrist you can usually get up quite soon. The pressure band on the wrist is gradually loosened and removed over a few hours. If the groin was used, you may be asked to stay in bed for a few hours. For a few days you are advised not to lift heavy objects with that arm or strain the wrist. Contact your doctor if you notice swelling, increasing pain or bleeding at the access site, or numbness or coldness in the hand. If a stent or drug-coated balloon was used, you will be given medicines that prevent blood clots (antiplatelets and, if needed, blood thinners). It is very important to take them without missing doses for as long as your doctor recommends. Do not stop them without talking to your cardiologist, even before another treatment or a dental procedure. A stent opens the narrowing, but it does not remove the underlying artery disease. Regular check-ups, keeping cholesterol, blood pressure and blood sugar under control, stopping smoking, regular activity and a healthy diet help slow the disease down.

Risks

Like every interventional procedure, angiography and stenting have risks. These include bleeding, bruising or swelling at the access site; an allergic reaction to the contrast dye; a decline in kidney function; injury to the artery; and heart rhythm disturbances. Less commonly, serious complications such as a heart attack, stroke, a clot forming in the stent or the need for emergency surgery can occur. Over time the artery can also narrow again inside the stent. Your doctor will explain the possible benefits and risks for you in detail, based on your personal situation, before the procedure.

Frequently asked questions

Am I awake during the procedure, and does it hurt? You are usually awake. Because the wrist is numbed with local anaesthetic, most people do not feel significant pain. You may feel brief warmth when the dye is given, and brief chest pressure while the balloon is inflated.
Is a stent placed at every angiogram? No. The angiogram is first a diagnostic test. A stent is placed only when a narrowing that needs treatment is found and stenting is suitable. For some patients medication or bypass surgery may be more appropriate; these options are explained to you separately.
What is a drug-coated balloon, and can it be used instead of a stent? A drug-coated balloon is a balloon coated with medicine that leaves no permanent mesh in the artery. It can be used in some situations, such as renewed narrowing inside a stent; for renewed narrowing inside a drug-eluting stent, a new drug-eluting stent is usually preferred. Your doctor decides whether it suits you based on the angiogram findings.
Why is the procedure done through the wrist? Current guidelines recommend the wrist as the standard route in suitable patients. After a procedure through the wrist you can usually get up quite soon. If the wrist artery is not suitable, the groin is used.
How long will I need to take my medicines after a stent? Your doctor decides how long you need the anti-clotting medicines, based on the reason for the procedure and your personal bleeding risk. Do not stop them before that time without talking to your doctor.

Medical content reviewed and approved by Prof. Dr. Barış Kılıçaslan. Last updated: 4 October 2026. Editor: Baran Zeydan (info@clinixcrm.app).