CT Coronary Angiography

Non-invasive 3D mapping of the coronary arteries using IV contrast on a 128-slice Siemens scanner. Detects calcified and non-calcified plaques, grades stenosis, and identifies coronary anomalies — without catheter insertion or hospitalisation.

CT coronary angiography at Sanador Hospital is performed on the Siemens CT Definition Edge 128-slice scanner, which captures the coronary arterial tree in a single cardiac-gated acquisition. Unlike conventional coronary catheterisation, no catheter is introduced into the body; instead, an intravenous injection of iodine-based contrast is timed to perfuse the coronary arteries during the scan, allowing the scanner to image the lumen and wall of the left main, left anterior descending, left circumflex, and right coronary arteries in high-resolution cross-section. The clinical information CT coronary angiography provides goes considerably beyond what calcium scoring alone can offer. While the calcium score quantifies total calcific plaque burden, CT angiography visualises the vessel lumen itself — revealing whether any plaque, calcified or not, has narrowed the artery to a haemodynamically significant degree. Non-calcified, lipid-rich plaques are the most dangerous type: they carry the highest risk of sudden rupture and acute myocardial infarction, and they are completely invisible to calcium scoring. CT coronary angiography is the only non-invasive test that can identify them. The 128-slice Definition Edge at Sanador acquires images with isotropic sub-millimetre resolution. The resulting volumetric dataset is reconstructed in multiple planes and as a three-dimensional model of the coronary tree, allowing the radiologist to trace each vessel from its origin to its distal branches and grade any stenosis by its estimated percentage reduction in luminal diameter. Segments with intermediate stenosis (40–70%) can be flagged for stress testing or functional assessment. Pre-examination preparation includes avoiding caffeine, nicotine, and strenuous exercise for several hours beforehand. Patients taking metformin should discuss discontinuation timing with the team before contrast administration. Current renal function (serum creatinine) is needed if there is any history of kidney disease. Beta-blockers to lower heart rate may be administered before the scan if resting heart rate is above 65 bpm, as a slower, regular rhythm improves image quality and reduces radiation dose. Sanador operates the cardiology and imaging departments 24 hours a day, meaning urgent or same-day appointments are routinely possible. The combined coronary angiography and calcium score package is published at €550 on the English website, making it among the most competitively priced full cardiac CT offerings in Central and Eastern Europe. Self-pay and medical tourism patients do not require a local GP referral to book.