Patient Preparation

Dr . Hesham Kamal, MD
Lecturer of Cariology- Ain Shams University
MRCP- UK
 History taking
Indication for Catheterization.
Contra-indication for Cathetrization.
Comorbidities e.g. renal ds., PAD
Risk factors e.g. DM
Previous history for revascularization:
-time
- methode
Allergy to contrast.
Previous complication during Catheterization.
 Examination
 Peripheral pulses (before and after procedure).

 ABP.

 TEMP.

 Chest auscultation.

 Cardiac auscultation
 investigations
-LABs:
Coagulation profile.
Renal function.
CBC.
Viral markers

-ECG: documented ischemia- arrythmias

-ECHO: documented ischemia- LV

function-scar/Akinesia- Valve ds.
- Stress test: documented ischemia-

- Viability test: If akinesia and NO chest pain-

territory verification

- MSCT
 Communication
 Patient education ….. Procedure important details.

Informed consent…..written (unless SHOCKED

verbal wittnessed).

Good oral hydration

 Immediate Before…..
 Sedation….2 mg midazolam

 IV antibiotics preoperative…….. No evidence

Previous allergy/ routine ??…… 100 mg

hydrocortisone
50 mg diphenhydramine
 Prohylaxis against CIN
Hydration with isotonic saline is recommended. I

Use of low-osmolar or iso-osmolar contrast media is

recommended . I

 contast volume<350 mL or <4 mL/kg or total contrast

volume/GFR <4.

Short-term, high-dose statin therapy should be considered.

Rosuvastatin 40/20mg or atorvastatin 80 mg or simvastatin
80 mg.
Iso-osmolar contrast media should be considered over
low-osmolar contrast media.

Prophylactic haemofiltration 6 hours before complex

PCI may be considered. IIb