Cardiac MRI in European countries

Question:  Is Cardiac MRI testing commonly or widely available in European countries such as France, Germany, England and Spain?

[jrbon]

I got no problem to get it done in Madrid - Spain... but you need a cardiologist to prescribe it.

Do you think will be more convenient for you to come to Spain to do it??

Jesus.

[Irishking23]

Was there any special reason why your cardiologist prescribed a cardiac MRI instead of say a heart catheterization with angiography?   I am not sure which test would give the best and most accurate picture of the heart's arteries and occlusions or narrowings.

[jrbon]

That is a completely different question ...

The best picture of arteries occlusion is made, as you indicates with Cath and angiography.

In my case after 5 stents, several echos, 1 Spec, the MRI was done (2 years after the  stents) to see if there were left any "viable" part of the myocardium that could benefit from a further re-vascularization.

The MRI, does NOT look particularly, at the arteries but at the cardiac muscle to see how the resonance contrast (Gadolinium) reach the whole muscle.

Jesus

[Irishking23]

You're right. I did alter and augment my initial question.  I too  underwent a Cardiac MRI as a 'viability' study after having first gone through two Heart Caths and angiograms, 2 to 3 echos, Spect scan and others without any stenting.   The heart surgeon then wanted to perform cardiac bypass surgery mainly due to a 50% occlusion in the Left Main Coronary Artery (LMCA) and I agreed.


My wife has an in-law in France who had some blocked leg arteries and stents put in.

[ed34]

I think for artery condition, IVUS is probably the best. It's Intravascular Ultrasound. It gives a 360-degree view of the arterial wall from the inside, allowing a more complete and accurate assessment than is possible with standard angiography. It enables the cardiologist to determine the composition of the blockage, aiding with risk calculations. Armed with added FFR, the difference in blood flow/pressure across the blockage can be seen.

[Irishking23]

I never heard of IVUS before and my cardiologist never mentioned it as an option when I was being put through a long series of tests in Indianapolis to get a better handle on coronary artery narrowings or occulsions.    He jumped from a Heart Cath with angiogram to a Cardiac MRI.   Perhaps it is the cost of doing an IVUS which makes it less popular.  Health insurance companies may not want to pay for it as a diagnostic tool.

[ed34]

maybe. I know it was used in research on hundreds of patients to try and get a greater understanding of CAD. They first did all the stenting necessary of the patients, and then did a thorough mapping of their arteries, showing where the disease was, the extent of the disease and the composition. They then followed the patients over three years to see how well they did. Most of the returns to hospital from angina were from new blockages, some had more than doubled in size in around 50 weeks, so it's not always slow growing. They did discover many things, such as, which type of occlusion (composition) would most likely cause problems over the next few years. There are some occlusion types which don't require stenting because they don't seem to ever create problems. I'm not certain if ALL cath labs have this technology available. FFR is certainly available in cath Labs, a small sensor on the end of the catheter. It continually gives readings of blood flow/pressure as it is passed along an artery. So if the readings suddenly significantly drop when it's passed over a blockage, then it should be stented.

[Irishking23]

I asked my cardiac care nurse in cardiac rehab if she knows what IVUS is and she acted at first like it was a strange term but then said 'looking inside arteries.'

Think I'll name my next dog IVUS.

[ed34]

lol, I like it.

[Irishking23]

I thank everyone for their response.  I also thank Ed34 for his excellent ideas and good humor.

[ed34]

Just promise to send me a picture of IVUS when you get him :D